Document Detail

Characterization of cerebral white matter damage in preterm infants using 1H and 31P magnetic resonance spectroscopy.
MedLine Citation:
PMID:  11043907     Owner:  NLM     Status:  MEDLINE    
The biochemical characteristics of white matter damage (WMD) in preterm infants were assessed using magnetic resonance spectroscopy (MRS). The authors hypothesized that preterm infants with WMD at term had a persisting cerebral lactic alkalosis and reduced N-acetyl aspartate (NAA)/ creatine plus phosphocreatine (Cr), similar to that previously documented in term infants weeks after perinatal hypoxiaischemia (HI). Thirty infants (gestational age 27.9 +/- 3.1 weeks, birth weight 1,122 +/- 445 g) were studied at postnatal age of 9.8 +/- 4.1 weeks (corrected age 40.3 +/- 3.9 weeks). Infants were grouped according to the presence or absence of WMD on magnetic resonance (MR) images. The peak area ratios of lactate/Cr, NAA/Cr, myo-inositol/Cr, and choline (Cho)/Cr were measured from an 8-cm3 voxel in the posterior periventricular white matter (WM) using proton MRS. Intracellular pH (pHi) was calculated using phosphorus MRS. Eighteen infants had normal WM on MR imaging; 12 had WMD. For infants with WMD, lactate/Cr and myo-inositol/Cr were related (P < 0.01); lactate/Cr and pHi were not (P = 0.8). In the WMD group, mean lactate/Cr and myo-inositol/Cr were higher (P < 0.001, P < 0.05, respectively) than the normal WM group. There was no difference in the NAA/Cr, Cho/Cr, or pHi between the two groups, although pHi was not measured in all infants. These findings suggest that WMD in the preterm infant at term has a different biochemical profile compared with the term infant after perinatal HI.
N J Robertson; J Kuint; T J Counsell; T A Rutherford; A Coutts; I J Cox; A D Edwards
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  20     ISSN:  0271-678X     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-23     Completed Date:  2000-11-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1446-56     Citation Subset:  IM    
Department of Pediatrics, Imperial College School of Medicine, London, UK.
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MeSH Terms
Brain / metabolism*,  pathology*
Creatine / metabolism
Infant, Newborn
Infant, Premature*
Inositol / metabolism
Lactic Acid / metabolism
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy*
Phosphocreatine / metabolism
Prospective Studies
Reference Values
Reg. No./Substance:
0/Protons; 50-21-5/Lactic Acid; 57-00-1/Creatine; 67-07-2/Phosphocreatine; 6917-35-7/Inositol; 7723-14-0/Phosphorus

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