1H magnetic resonance spectroscopy in human hydrocephalus.
OBJECTIVE
To evaluate cerebral metabolism in clinical hydrocephalus with (1)H magnetic resonance spectroscopy (MRS).


METHODS
In 24 children and adults with progressive, arrested, or normal pressure hydrocephalus, long-echo time (1)H MR spectra were acquired from periventricular white matter and intraventricular cerebrospinal fluid (CSF). Metabolite ratios, and the presence of lactate, were compared with 38 age-matched controls.


RESULTS
Metabolite ratios of patients were within the 95% confidence interval (CI) of controls. A small lactate resonance was detected in 20% of control and hydrocephalic subjects. Lactate was consistently visible in CSF spectra, though lactate concentrations were normal. The CSF lactate T(2) was long in comparison with the known intracellular metabolite T(2) relaxation times. In three neonates with hydrocephalus and spina bifida, 3-hydroxybutyrate was detected in CSF in vivo.


CONCLUSIONS
Within the limits of the present methods, (1)H MRS could not detect cerebral metabolic abnormalities in human hydrocephalus and provided no additional diagnostic information. The long T(2) of lactate in CSF explains its high visibility. Hence, the detection of lactate in spectra acquired from voxels that contain CSF does not necessarily imply cerebral ischemia.
Braun
Kees P J
KP
Department of Child Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. K.Braun@wkz.azu.nl
Gooskens
Rob H J M
RH
Vandertop
W Peter
WP
Tulleken
Cees A F
CA
van der Grond
Jeroen
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D006801:Humans; D006849:Hydrocephalus / Q000378:metabolism*; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000134:cerebrospinal fluid; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged
D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline