title: Chemical shift imaging and localised magnetic resonance spectroscopy in full-term asphyxiated neonates.
abstract: BACKGROUND
  Diagnosis of brain lesions after birth anoxia-ischemia is essential for appropriate management. Clinical evaluation is not sufficient. MRI has been proven to provide useful information.
  
  
  OBJECTIVE
  To compare abnormalities observed with MRI, including diffusion-weighted imaging (DWI), localised magnetic resonance spectroscopy (MRS) and chemical shift imaging (CSI) and correlate these findings with the clinical outcome.
  
  
  METHODS
  Fourteen full-term neonates with birth asphyxia were studied. MRI, MRS and CSI were performed within the first 4 days of life.
  
  
  RESULTS
  Lesions observed with DWI were correlated with outcome, but the apparent diffusion coefficient (ADC) did improve diagnostic confidence. The mean value of Lac/Cr for the neonates with a favourable outcome was statically lower than for those who died (0.22 vs 1.04; P = 0.01). The same results were observed for the Lac/NAA ratio (0.21 vs 1.23; P = 0.01). Data obtained with localised MRS and CSI were correlated for the ratio N-acetyl-aspartate/choline, but not for the other metabolites. No correlation was found between the ADC values and the metabolite ratios.
  
  
  CONCLUSIONS
  Combination of these techniques could be helpful in our understanding of the physiopathological events occurring in neonates with asphyxia.
authors.affiliation: Paediatric Intensive Care Unit, Children's Hospital, Place Amélie Raba Léon, Bordeaux 33076, France. olivier.brissaud@chu-bordeaux.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Brissaud
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Chateil
authors.forename: Martine
authors.initials: M
authors.lastname: Bordessoules
authors.forename: Muriel
authors.initials: M
authors.lastname: Brun
mesh_terms: D001034:Apgar Score; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001238:Asphyxia Neonatorum / Q000401:mortality / Q000473:pathology*; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019344:Lactic Acid / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D012640:Seizures / Q000150:complications
chemical_list: D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline