Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Res. 2013 Jul;74(1):75-81. doi: 10.1038/pr.2013.62. Epub 2013 Apr 10.
Magnetic resonance spectroscopy allows for the noninvasive study of brain metabolism and therefore may provide useful information about brain injuries. We examined the associations of brain metabolite ratios in very preterm infants with white matter lesions and overall health status at birth.
Spectroscopy data were obtained from 99 very preterm infants (born ≤32 wk gestation) imaged shortly after birth and from 67 of these infants at term-equivalent age. These data were processed using LCModel. Multiple regression was used to examine the association of metabolite ratios with focal noncystic white matter lesions visible on conventional magnetic resonance imaging (MRI) and with at-birth illness severity scores.
Within 2 wk of birth, the ratio of N-acetylaspartate + N-acetylaspartylglutamate to creatine + phosphocreatine was significantly lower in those infants showing white matter abnormalities on conventional MRI. Increased lactate to creatine + phosphocreatine and lactate to glycerophosphocholine + phosphocholine ratios were significantly associated with increasing severity of Clinical Risk Index for Babies II and Apgar scores taken at 1 and 5 min after birth.
Both overall health status at birth and white matter injury in preterm neonates are reflected in metabolite ratios measured shortly after birth. Long-term follow-up will provide additional insight into the prognostic value of these measures.
磁共振波谱分析可以对脑代谢进行非侵入性研究，因此可能提供有关脑损伤的有用信息。我们研究了极早产儿脑代谢物比值与出生时脑白质病变和整体健康状况的关系。
对 99 名出生后≤32 周的极早产儿进行了波谱数据分析，并对其中 67 名婴儿在足月时进行了分析。这些数据使用 LCModel 进行处理。多元回归用于检查代谢物比值与常规磁共振成像（MRI）上可见的局灶性非囊性脑白质病变以及出生时疾病严重程度评分之间的关系。
出生后 2 周内，在常规 MRI 显示脑白质异常的婴儿中，N-乙酰天冬氨酸+N-乙酰天门冬氨酸谷氨酸与肌酸+磷酸肌酸的比值明显降低。乳酸/肌酸+磷酸肌酸和乳酸/甘油磷酸胆碱+磷酸胆碱的比值与出生后 1 分钟和 5 分钟的临床风险指数婴儿 II（Clinical Risk Index for Babies II）和 Apgar 评分的严重程度增加显著相关。
出生时的整体健康状况和早产儿脑白质损伤都反映在出生后不久测量的代谢物比值中。长期随访将提供这些指标预后价值的更多信息。
