title: Brain metabolism in fetal intrauterine growth restriction: a proton magnetic resonance spectroscopy study.
abstract: OBJECTIVE
  The purpose of this study was to investigate alterations in brain metabolism in fetuses with intrauterine growth restriction (IUGR) and evidence of cerebral redistribution of blood flow.
  
  
  METHODS
  Biometry and Doppler assessment of blood flow was assessed with ultrasound in 28 fetuses with IUGR and cerebral redistribution and in 41 appropriately grown control subjects. Proton magnetic resonance spectroscopy of the fetal brain was then performed to determine the presence of choline (Cho), creatine (Cr), N-acetylaspartate (NAA), and lactate and to generate ratios for NAA:Cho, NAA:Cr, and Cho:Cr.
  
  
  RESULTS
  Sixty-five percent of spectra were interpretable: N-acetylaspartate, choline, and creatine peaks were identified in all these spectra; lactate was present in 5 IUGR fetuses and in 3 appropriately grown fetuses. NAA:Cr and NAA:Cho ratios were significantly lower in IUGR fetuses with cerebral redistribution.
  
  
  CONCLUSIONS
  Cerebral redistribution is associated with altered brain metabolism that is evidenced by a reduction in NAA:Cho and NAA:Cr ratios.
authors.affiliation: Robert Steiner MRI Unit, Imperial College London, London, England, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Story
authors.forename: Mellisa S
authors.initials: MS
authors.lastname: Damodaram
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Allsop
authors.forename: Amy
authors.initials: A
authors.lastname: McGuinness
authors.forename: Abhilasha
authors.initials: A
authors.lastname: Patel
authors.forename: Marzena
authors.initials: M
authors.lastname: Wylezinska
authors.forename: Henrik
authors.initials: H
authors.lastname: Hagberg
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Mary A
authors.initials: MA
authors.lastname: Rutherford
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000196:embryology / Q000378:metabolism*; D005260:Female; D005317:Fetal Growth Retardation / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D011247:Pregnancy