1H magnetic resonance spectroscopy of the brains of normal infants and after perinatal hypoxia-ischaemia.

The aims of this study were to define proton (1H) metabolite peak-area ratios in the brains of normal infants and to investigate abnormalities after perinatal hypoxia-ischemia. Point-resolved spectroscopy (PRESS) data were collected at 2.4 T with an echo time (TE) of 270 ms from 8-ml voxels located in the thalamus or occipito-parietal region. Fourteen normal and 9 asphyxiated infants were studied. The gestational plus postnatal ages (GPA) of these two groups were 31–41 (median 36) and 27–41 (37) weeks, respectively, and the asphyxiated infants were studied aged 0–10 (2) days. Peak-area ratios were determined in the normal infants for choline-containing compounds (Cho), creatine plus phosphocreatine (Cr),N-acetylaspartate (NAA) and lactate (Lac). Lactate was detected in all the normal infants and Lac/NAA was higher in the occipito-parietal region than in the thalamus (p<0.005). Lac/NAA decreased with increasing GPA in both the thalamus (p=0.014) and the occipito-parietal region (p=0.033). In six of the nine asphyxiated infants, Lac/NAA was above 95% confidence intervals for either the thalamus and/or the occipito-parietal region. Of these six infants, two died and three were neurologically abnormal aged 2 months, indicating that elevated Lac/NAA after perinatal hypoxia-ischemia may convey a poor prognosis. Propan-l,2-diol (the phenobarbitone injection medium) was detected at ∼ 1.1 ppm in three infants.