Chemical shift imaging and localised magnetic resonance spectroscopy in full-term asphyxiated neonates.
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.
Brissaud
Olivier
O
Paediatric Intensive Care Unit, Children's Hospital, Place Amélie Raba Léon, Bordeaux 33076, France. olivier.brissaud@chu-bordeaux.fr
Chateil
Jean-François
JF
Bordessoules
Martine
M
Brun
Muriel
M
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
D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline