PT  - JOURNAL ARTICLE
AU  - Yonglin Pu
AU  - Qing-Feng Li
AU  - Chao-Mei Zeng
AU  - Jian Gao
AU  - Jing Qi
AU  - De-Xin Luo
AU  - Srikanth Mahankali
AU  - Peter T. Fox
AU  - Jia-Hong Gao
TI  - Increased Detectability of Alpha Brain Glutamate/Glutamine in Neonatal Hypoxic-Ischemic Encephalopathy
DP  - 2000 Jan 01
TA  - American Journal of Neuroradiology
PG  - 203--212
VI  - 21
IP  - 1
4099  - http://www.ajnr.org/content/21/1/203.short
4100  - http://www.ajnr.org/content/21/1/203.full
SO  - Am. J. Neuroradiol.2000 Jan 01; 21
AB  - 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 α-CH protons of Glx (α-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 α-Glx was assessed by two different parameters: the detection rate of the α-Glx peak and the peak-area ratio of α-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 α-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 α-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 α-Glx peak on both the initial and follow-up studies with the STEAM sequence.CONCLUSION: Proton MRS detectability of α-Glx is increased in moderate and severe HIE and correlates with the Sarnat stage of HIE.