Magnetic resonance spectroscopy in neonatal hypoxic-ischaemic insults.
This article aims to review the major achievements of phosphorus (31P) and proton (1H) magnetic resonance spectroscopy (MRS) in the field of perinatal hypoxic-ischaemic cerebral injury. Methodologies for applying MRS to the routine study of the infant brain are now well developed. Both 31P and 1H MRS reveal gross abnormalities in severe hypoxic-ischaemic injury--in 31P studies [phosphocreatine] and [adenosine triphosphate] are low whilst [inorganic phosphate] is high; 1H MRS reveals high [lactate] and reduced [N-acetylaspartate]. The 31P abnormalities are not apparent in early spectra but develop after 12-24 h--a phenomenon termed "secondary energy failure". These metabolic changes have now been modelled, and investigations of cerebroprotective therapies are underway. Extensive long-term studies have revealed that both 31P and 1H MRS, performed within a few days of birth, have great prognostic utility.
Cady
E B
EB
Department of Medical Physics and Bio-Engineering, University College London Hospitals NHS Trust, London, UK. jupiter@unforgettable.com
D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002658:Developmental Disabilities / Q000517:prevention & control*; D006801:Humans; D006859:Hydrogen; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis*; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000175:diagnosis / Q000517:prevention & control; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D010759:Phosphorus Isotopes; D011379:Prognosis; D011522:Protons
D010759:Phosphorus Isotopes; D011522:Protons; D006859:Hydrogen