PEDIATRICS Vol. 87 No. 3 March 1991, pp. 273-282
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Spatially Localized Magnetic Resonance Spectroscopy of the Brains of Normal and Asphyxiated Newborns

J. Moorcraft BM, MRCP1, N. M. Bolas MA, DPhil1, N. K. Ives MBBS, MRCP1, P. Sutton 1, M. J. Blackledge BSc, DPhil1, B. Rajagopalan MA, BM, DPhil, FRCP1, P. L. Hope MBBS, MRCP1, and G. K. Radda MA, DPhil, FRS1

1 From the Department of Paediatrics and Medical Research Council Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, United Kingdom

Phase-modulated rotating frame imaging is a modification of magnetic resonance spectroscopy, which uses a linear radiofrequency field gradient to obtain spatially localized biochemical information. Phase-modulated rotating frame imaging was used to study regional cerebral energy metabolism in the brains of 9 normal newborns and 25 newborns after birth asphyxia. Relative concentrations of phosphorus-containing metabolites and intracellular pH were determined for brain tissue at three specified depths below the brain surface for all neonates. Wide variations in metabolite ratios were seen among normal neonates, and considerable metabolic heterogeneity was demonstrated in individual neonates by depth-resolved spectroscopy. Asphyxiated neonates with severe hypoxic-ischemic encephalopathy and a poor neurodevelopmental outcome showed the expected rise in inorganic orthophosphate and fall in phosphocreatine concentrations in both global and spatially localized spectra. Phase-modulated rotating frame imaging showed that metabolic derangement was less in superficial than in deeper brain tissue. The inorganic orthophosphateadenosine triphosphate ratio from 1 to 2 cm below the brain surface was more accurate than any global metabolite ratio for the identification of neonates with a poor short-term outcome. These data are consistent with the known vulnerability of subcortical brain tissue to hypoxic-ischemic injury in the full-term neonate.

Key Words: birth asphyxia • cerebral metabolism • magnetic resonance spectroscopy • neonates

Submitted on July 16, 1990
Accepted on October 15, 1990




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