Metabolic assessment of the brain using proton magnetic resonance spectroscopy in a growth-restricted human fetus: case report

Am J Perinatol. 2008 May;25(5):305-9. doi: 10.1055/s-2008-1076603. Epub 2008 Apr 24.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / analysis
  • Brain / embryology*
  • Brain / metabolism*
  • Brain Chemistry
  • Child, Preschool
  • Choline / analysis
  • Female
  • Fetal Growth Retardation / physiopathology*
  • Fetal Hypoxia / diagnosis
  • Fetus / metabolism*
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Lactic Acid / analysis
  • Magnetic Resonance Spectroscopy*
  • Pregnancy
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal
  • Umbilical Arteries / diagnostic imaging

Substances

  • Aspartic Acid
  • Lactic Acid
  • N-acetylaspartate
  • Choline