Metabolic Assessment of the Brain Using Proton Magnetic Resonance Spectroscopy in a Growth-Restricted Human Fetus: Case Report
Abstract
Proton magnetic resonance spectroscopy (MRS) is a noninvasive method to assess concentrations of different metabolites in tissues, including the brain. We evaluated a fetus with growth restriction using Doppler ultrasound and proton MRS. Doppler assessment revealed absent end diastolic flow in the umbilical artery. Diastolic flow was increased in the middle cerebral artery. Proton MRS of the fetal brain showed lactate and a low N-acetylaspartate/choline index, metabolic markers of starvation/hypoxia. Proton MRS gave us in vivo metabolic information of the brain of a fetus under starvation/hypoxic conditions. It is potentially a new tool for fetal surveillance. To our knowledge, this is the first report of cerebral lactate detection using proton MRS in a growth-restricted human fetus with no associated malformations in the English literature. Further experimental and clinical longitudinal investigations are needed to evaluate its efficacy in the clinical setting.
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Cerebral lactate is a marker of anaerobic metabolism in the newborn and fetus, has been found in up to 50% of preoperative infants with congenital heart disease, and is associated with adverse outcome in other high-risk infants.
“Cerebral lactate, a marker of anaerobic metabolism in the newborn and fetus [38,39], has been found in up to 50% of preoperative infants with CHD [14,15] and is associated with adverse outcome in other high-risk infants [40].”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [38]
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Limperopoulos, C., Tworetzky, W., McElhinney, D. B., Newburger, J. W., Brown, D. W., Robertson, R. L., Guizard, N., McGrath, E., Geva, J., Annese, D., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.865568 · Cited by 663 · see citing works
- Authors
- Azpurua, H., Alvarado, A., Mayobre, F., Salom, T., Copel, J., & Guevara-Zuloaga, F.
- Affiliations
- Yale University (US)
- Universidad Central de Venezuela (VE)
- Venue
- American Journal of Perinatology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2008-04
- Volume
- 25
- Issue
- 5
- Pages
- 305-309
- ISSN
- 0735-1631 (ISSN-L)
- 1098-8785
- OpenAlex
- W2083794006
- Cited by
- 36
- References
- 0
- Citations by year
- 2022: 1 · 2020: 1 · 2019: 1 · 2017: 1 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 8
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Perinatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- fetal growth restriction, fetal brain metabolism, 1H NMR, lactate, N-acetylaspartate, choline, fetal hypoxia, middle cerebral artery, fetal monitoring, Doppler ultrasound
- MeSH terms
- Adult, Aspartic Acid, Brain, Brain Chemistry, Child, Preschool, Choline, Female, Fetal Hypoxia, Fetal Growth Retardation, Fetus, Follow-Up Studies, Humans, Infant, Newborn, Magnetic Resonance Spectroscopy, Pregnancy, Umbilical Arteries, Ultrasonography, Prenatal, Ultrasonography, Doppler, Lactic Acid
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