Hope P L, Moorcraft J
John Radcliffe Hospital, Oxford, England.
Clin Perinatol. 1991 Sep;18(3):535-48.
MRS is a noninvasive technique that does not use ionizing radiation and can be used to measure relative metabolite concentrations in human tissues and organs in vivo. Phosphorus MRS can be used to study energy metabolites and intracellular pH. The first neonatal applications were described in 1983 in a study of cerebral metabolism. Since then, the value of cerebral MRS as research tool and an investigative technique has been confirmed, and its prognostic power in asphyxiated infants has been established. Techniques of spatial localization and quantitation have been developed, but studies of other organs and the use of other nuclei remain at a very preliminary stage. Considering the huge potential of MRS and the proliferation of high field magnets primarily designed for imaging, there has been a disappointing lack of progress in the development of clinical and research applications of spectroscopy. The logistic differences of studying sick infants in strong magnetic fields make MRS a time-consuming and labor-intensive investigation, which will inevitably limit its widespread routine use. Research studies are hampered by the diversity of spectroscopic and signal processing techniques, which make comparisons of data from different groups impossible. Some techniques for the assessment of cerebral hemodynamics such as doppler ultrasound and near infrared spectroscopy have the advantage of being available at the cotside, but MRS is unique in providing quantitative information about a wide range of intracellular metabolites. The altricial development of MRS as a clinical investigative tool in neonatology can be ascribed partly to practical difficulties, but these should not detract from the exciting possibilities opened up by a technique that gives a noninvasive insight into intracellular chemistry. The metabolic information from MRS is an invaluable addition to the information provided by other techniques and will certainly play an important role in unraveling the sequence of events between an hypoxic-ischemic insult and cell death. A better understanding of these mechanisms is a prerequisite to the development of rational therapeutic maneuvers following asphyxial insults.
磁共振波谱（MRS）是一种非侵入性技术，不使用电离辐射，可用于在体内测量人体组织和器官中的相对代谢物浓度。磷磁共振波谱可用于研究能量代谢物和细胞内pH值。1983年在一项脑代谢研究中首次描述了其在新生儿中的应用。从那时起，脑MRS作为一种研究工具和调查技术的价值得到了证实，其在窒息婴儿中的预后能力也已确立。空间定位和定量技术已经得到发展，但对其他器官的研究以及其他原子核的使用仍处于非常初步的阶段。考虑到MRS的巨大潜力以及主要为成像设计的高场磁体的激增，光谱学临床和研究应用的开发进展令人失望。在强磁场中研究患病婴儿的后勤差异使得MRS成为一项耗时且费力的检查，这将不可避免地限制其广泛的常规使用。研究受到光谱和信号处理技术多样性的阻碍，这使得不同组数据的比较变得不可能。一些评估脑血流动力学的技术，如多普勒超声和近红外光谱，具有可在床边使用的优势，但MRS在提供关于多种细胞内代谢物的定量信息方面是独一无二的。MRS作为新生儿科临床调查工具的发育不全部分可归因于实际困难，但这些不应减损该技术所带来的令人兴奋的可能性，该技术能对细胞内化学进行非侵入性洞察。MRS提供的代谢信息是对其他技术所提供信息的宝贵补充，肯定会在揭示缺氧缺血性损伤与细胞死亡之间的事件序列中发挥重要作用。更好地理解这些机制是在窒息性损伤后制定合理治疗策略的先决条件。
