Proton magnetic resonance spectroscopy (MRS) is a noninvasive method to assess concentrations of different metabolites in tissues, including the brain. We evaluated a fetus with growth restriction using Doppler ultrasound and proton MRS. Doppler assessment revealed absent end diastolic flow in the umbilical artery. Diastolic flow was increased in the middle cerebral artery. Proton MRS of the fetal brain showed lactate and a low N-acetylaspartate/choline index, metabolic markers of starvation/hypoxia. Proton MRS gave us in vivo metabolic information of the brain of a fetus under starvation/hypoxic conditions. It is potentially a new tool for fetal surveillance. To our knowledge, this is the first report of cerebral lactate detection using proton MRS in a growth-restricted human fetus with no associated malformations in the English literature. Further experimental and clinical longitudinal investigations are needed to evaluate its efficacy in the clinical setting.

A new methodology has been developed for the evaluation and segmentation of brain tumors using information obtained by different magnetic resonance techniques such as in vivo proton magnetic resonance spectroscopy (1HMRS) and relaxometry. In vivo 1HMRS may be used as a preoperative technique that allows noninvasive monitoring of metabolites to identify the different tissue types present in the lesion (active tumor, necrotic tissue, edema, and normal or non-affected tissue). Spatial resolution for treatment consideration may be improved by using 1HMRS combined or fused with images obtained by relaxometry which exhibit excellent spatial resolution. Some segmentation schemes are presented and discussed. The results show that segmentation performed in this way efficiently determines the spatial localization of the tumor both qualitatively and quantitatively. It provides appropriate information for therapy planning and application of therapies such as radiosurgery or radiotherapy and future control of patient evolution.