American Journal of Neuroradiology 21:203-212 (1 2000)
© 2000 American Society of Neuroradiology
ARTICLE
Increased Detectability of Alpha Brain Glutamate/Glutamine in Neonatal Hypoxic-Ischemic Encephalopathy
a From The People's Hospital of The Beijing Medical University, Beijing, The People's Republic of China (Y.P., Q-F.L., C-M.Z., J.G., J.Q., D-X.L.), and Research Imaging Center, University of Texas Health Science Center, San Antonio, TX (Y.P., S.M., P.T.F., J-H.G.).
BACKGROUND AND PURPOSE: Proton MR spectroscopy (MRS) detectability of brain glutamate/glutamine (Glx) is increased in hypoxic-ischemic insults and is implicated in the neuronal injury and death that follows. Our aim was to correlate the proton MRS detectability of 
-CH protons of Glx (-Glx) with the Sarnat stage of neonatal hypoxic-ischemic encephalopathy (HIE).
METHODS: Initial and follow-up proton MRS studies at 1.9 T were performed in 28 neonates aged 1 to 7 days (seven healthy control subjects and 21 with HIE: 10 mild, nine moderate, and two severe) and in 12 neonates aged 13 to 17 days (12 with HIE: eight mild, three moderate, and one severe), respectively. Both point-resolved spectroscopy (PRESS) and stimulated-echo acquisition mode (STEAM) sequences were used. The spectral volume of interest was in the basal ganglia, thalami, and adjoining regions. The detectability of -Glx was assessed by two different parameters: the detection rate of the -Glx peak and the peak-area ratio of -Glx to creatine and phosphocreatine.
RESULTS: On both the initial and follow-up PRESS studies, all the neonates with moderate and severe HIE showed an -Glx peak, compared with one healthy control subject in the initial study and one neonate with mild HIE in both the studies. They also demonstrated a significantly higher peak-area ratio of -Glx/(creatine and phosphocreatine) on both the initial and follow-up studies. The peak-area ratios in neonates with HIE positively correlated with the Sarnat stage of HIE on both the initial and follow-up studies. Neonates with moderate and severe HIE also showed a consistently higher -Glx peak on both the initial and follow-up studies with the STEAM sequence.
CONCLUSION: Proton MRS detectability of -Glx is increased in moderate and severe HIE and correlates with the Sarnat stage of HIE.
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