磁共振波谱检测生长受限胎儿脑内乳酸。
Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy.
机构信息
Center for Fetal Research Giorgio Pardi, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
出版信息
Am J Obstet Gynecol. 2011 Oct;205(4):350.e1-7. doi: 10.1016/j.ajog.2011.06.020. Epub 2011 Jun 15.
OBJECTIVE
The objective of the study was to determine the feasibility of detecting fetal brain lactate, a marker of fetal metabolic acidemia, using a noninvasive technique, proton magnetic resonance spectroscopy ((1)H MRS), in intrauterine growth-restricted (IUGR) fetuses.
STUDY DESIGN
In vivo human fetal brain lactate detection was determined by (1)H MRS in 5 fetuses with IUGR. Oxygenation and acid-base balance data were obtained at birth.
RESULTS
(1)H MRS analysis showed the presence of a lactate peak in the brain of the most severely affected IUGR fetus, with abnormal umbilical artery Doppler and fetal heart rate tracing. This finding was consistent with the low oxygen content and high lactic acid concentration observed in umbilical blood obtained at delivery.
CONCLUSION
(1)H MRS allows the noninvasive detection of cerebral lactate in IUGR fetuses. Lactate detected by (1)H MRS may represent a possible marker of in utero cerebral injury or underperfusion.
目的
本研究旨在确定使用非侵入性技术——质子磁共振波谱（1H MRS）检测胎儿脑内乳酸（胎儿代谢性酸中毒的标志物）在宫内生长受限（IUGR）胎儿中的可行性。
研究设计
通过 1H MRS 在 5 例 IUGR 胎儿中进行体内人胎儿脑内乳酸检测。在出生时获得了氧合和酸碱平衡数据。
结果
1H MRS 分析显示，在最严重的 IUGR 胎儿的大脑中存在乳酸峰，伴有异常的脐动脉多普勒和胎儿心率描记。这一发现与分娩时获得的脐血中低氧含量和高乳酸浓度一致。
结论
1H MRS 可实现对 IUGR 胎儿脑内乳酸的非侵入性检测。1H MRS 检测到的乳酸可能代表宫内脑损伤或灌注不足的潜在标志物。
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