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利用质子磁共振波谱评估孕18周与孕40周之间胎儿脑生化成分的变化。

Evaluation of changes in biochemical composition of fetal brain between 18th and 40th gestational week in proton magnetic resonance spectroscopy.

作者信息

Urbanik Andrzej, Cichocka Monika, Kozub Justyna, Karcz Paulina, Herman-Sucharska Izabela

机构信息

a Department of Radiology , Collegium Medicum of the Jagiellonian University , Kraków , Poland.

b Department of Electroradiology , Collegium Medicum of the Jagiellonian University , Kraków , Poland.

出版信息

J Matern Fetal Neonatal Med. 2019 Aug;32(15):2493-2499. doi: 10.1080/14767058.2018.1439009. Epub 2018 Feb 20.

DOI:10.1080/14767058.2018.1439009
PMID:29463154
Abstract

INTRODUCTION

The aim of this study is to determine the right H MRS spectra of the brain in fetuses of different age, and then to define what metabolic changes occur between 18th and 40th weeks of pregnancy.

METHODS

H MRS studies of 32 fetuses aged 18-40 gestational weeks were performed, in which the MRI excluded central nervous system malformations. The studied group included 11 fetuses aged 18-25 weeks (the second half of the second trimester), 14 fetuses aged 26-33 weeks (the first half of the third trimester), and seven fetuses aged 34-40 weeks (the second half of the third trimester). The relative ratios of metabolites concentrations to the sum of all metabolites were calculated.

RESULTS

Increase in the concentrations of N-acetylaspartate (NAA), Cr, Cho, and myo-inositol (mI) with gestational age is statistically significant. Only increase in Glx is statistically insignificant. In the analyzed period of pregnancy also, an insignificant increase of NAA/Σ and Cr/Σ ratios and a decrease of mI/Σ, Cho/Σ and Glx/Σ ratios were noticed.

CONCLUSIONS

Changes in the H MRS spectrum are visible with increasing age of the fetus. All studied substances in fetal brain change their concentrations during pregnancy, which may be associated with the synaptic and dendritic development as well as myelination. Knowledge about the chemical changes in the fetal brain can provide valuable information in studies of the mechanisms of pregnancy and fetal development, define steps of brain metabolic development and explain reasons of pathologies.

摘要

引言

本研究的目的是确定不同孕周胎儿大脑的正确氢磁共振波谱(H MRS),进而明确妊娠第18至40周期间发生了哪些代谢变化。

方法

对32例孕18 - 40周的胎儿进行了H MRS研究,这些胎儿的磁共振成像(MRI)排除了中枢神经系统畸形。研究组包括11例孕18 - 25周(孕中期后半段)的胎儿、14例孕26 - 33周(孕晚期前半段)的胎儿以及7例孕34 - 40周(孕晚期后半段)的胎儿。计算了代谢物浓度与所有代谢物总和的相对比值。

结果

N - 乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)和肌醇(mI)的浓度随孕周增加具有统计学意义。只有谷氨酰胺和谷氨酸复合物(Glx)的增加无统计学意义。在分析的孕期内,还观察到NAA/总和及Cr/总和比值有不显著增加,而mI/总和、Cho/总和及Glx/总和比值有所下降。

结论

随着胎儿年龄增长,H MRS谱的变化可见。胎儿大脑中所有研究物质在孕期都会改变其浓度,这可能与突触和树突发育以及髓鞘形成有关。关于胎儿大脑化学变化的知识可为妊娠和胎儿发育机制的研究提供有价值的信息,明确脑代谢发育的阶段并解释病理原因。

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