Evaluation of the Antenatal Fetal Brain Metabolites using Proton Magnetic Resonance Spectroscopy.
- Author:
Jin Young MA
1
;
Hye Sung WON
;
Jeoung Kon KIM
;
So Ra KIM
;
Jae Yoon SHIM
;
Pil Ryang LEE
;
Ahm KIM
Author Information
1. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Proton MR spectroscopy;
Hypoxic injury;
Fetal brain;
Prenatal test
- MeSH:
Amniotic Fluid;
Apgar Score;
Blood Gas Analysis;
Blood Pressure;
Brain*;
Cardiotocography;
Choline;
Female;
Fetal Distress;
Fetus;
Humans;
Lactic Acid;
Magnetic Resonance Spectroscopy*;
Oligohydramnios;
Pregnancy;
Prenatal Diagnosis;
Prospective Studies;
Protons*;
Risk Factors;
Ultrasonography;
Umbilical Arteries;
Uterine Artery
- From:Korean Journal of Perinatology
2007;18(2):131-140
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE:The purpose of this study was to compare the sensitivity of proton Magnetic Resonance Spectrography (MRS) for estimating absolute metabolite concentrations and ratio of fetal brains. METHODS:Between September 2005 and August 2006, our study was prospective single center trial and included 39 healthy women (Group 1: fetuses with risk factor of fetal distress or hypoxic damage [n=15], Group 2: fetal CNS anomalies on ultrasound [n=12], Group 3: normal fetuses [n=12]). We quantified resonances for the main proton MRS-detectable brain and calculated metabolite ratios of the three groups. We compared the obtained metabolite levels of the three groups with electronic fetal cardiotocography, Doppler ultrasound examination, Apgar score, and umbilical artery blood gas analysis. RESULTS:Abnormal amniotic fluid, abnormal Doppler studies, and abnormal cardiotocograms were significantly more prevalent in Group 1 compared with those of Group 2 and 3. In Group 1, choline (Cho) levels (7.86+/-3.51mmol/L) were significantly higher than in Group 2 or 3 (p=0.024). The ratios of N-acetylasparate (NAA)/creatinine-phosphocreatine (Cr) and Cho/Cr were increased whereas the ratios of NAA/Cho, lactate (Lac)/Cho, Lac/NAA, and Lac/Cr were decreased; however, there was no statistical significance. In patients who have oligohydramnios and absence of umbilical diastolic flow, choline and N-acetylasparate levels were significantly elevated (p<0.05, p<0.05, respectively). But, MRS metabolites and ratios showed no significant differences for low Apgar scores, umbilical arterial academia, uterine artery notching, maternal blood pressure or abnormal fetal cardiotocograms. CONCLUSION:This study demonstrates the possibility of performing proton MRS to assess the metabolic information of the fetal brain. Further technical progress may be useful of improving the degree of detection of hypoxic changes or an impending hypoxic state for prenatal diagnosis.
