Metabolic Assessment of the Brain Using Proton Magnetic Resonance Spectroscopy in a Growth-Restricted Human Fetus: Case Report

Humberto Azpurua; Arturo Alvarado; Finita Mayobre; Tamara Salom; Joshua A. Copel; Freddy Guevara-Zuloaga

doi:10.1055/s-2008-1076603

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2008; 25(5): 305-309
DOI: 10.1055/s-2008-1076603

Metabolic Assessment of the Brain Using Proton Magnetic Resonance Spectroscopy in a Growth-Restricted Human Fetus: Case Report

Humberto Azpurua¹ , Arturo Alvarado² , Finita Mayobre³ , Tamara Salom⁴ , Joshua A. Copel¹ , Freddy Guevara-Zuloaga²

¹Yale University School of Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, New Haven, Connecticut
²Facultad de Medicina Universidad Central de Venezuela, Caracas, Venezuela
³Departamento de Espectroscopía y Desarrollo de Aplicaciones, Instituto de Resonancia Magnética, Caracas, Venezuela
⁴Unidad de Terapia Cognitiva, Av Circunvalacion, Centro profesional Santa Paula Torre B, Caracas, Venezuela

Abstract

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.

KEYWORDS

Fetal - brain - spectroscopy - lactate - growth - thrombophilia - pregnancy

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Referenzen

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Humberto AzpuruaM.D.

Yale University School of Medicine. Department of Obstetrics, Gynecology & Reproductive Sciences

333 Cedar St., PO Box 208063, New Haven, CT 06520