Proton MR Spectroscopy in Infants with Cerebral Energy Deficiency due to Hypoxia and Metabolic Disorders

Kugel, Harald; Heindel, Walter; Roth, Bernhard; Ernst, Sarah E.; Lackner, K.

doi:10.3109/02841859809175502

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Although lactate cannot be resolved in the adult human brain under normal conditions using a clinical machine of 1.5 T, strongly enhanced concentrations of cerebral lactate are often seen in disease states associated with an increased energy demand and/or impaired cellular capability for oxidative phosphorylation. A lactate peak observed by magnetic resonance spectroscopy (MRS) is present in tumours, 1–3 ischaemia 4,5 and other metabolic disorders 6 . Therefore, in clinical practice, the detection of lactate is a very important issue.…”

Section: Introductionmentioning

confidence: 99%

“…The existence of a lactate peak is useful to evaluate the severity and time‐course of cerebral infarction and to evaluate the malignancy of tumours. Up to now, most studies have evaluated lactate only by its presence or by relative ratios 1–6 . It would be extremely useful for clinical diagnosis if lactate could be determined quantitatively.…”

Section: Introductionmentioning

confidence: 99%

“…A lactate peak observed by magnetic resonance spectroscopy (MRS) is present in tumours, 1-3 ischaemia 4,5 and other metabolic disorders. 6 Therefore, in clinical practice, the detection of lactate is a very important issue. The existence of a lactate peak is useful to evaluate the severity and time-course of cerebral infarction and to evaluate the malignancy of tumours.…”

Section: Introductionmentioning

confidence: 99%

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Lactate quantification by proton magnetic resonance spectroscopy using a clinical MRI machine: A basic study

Isobe

Matsumura

Anno

et al. 2007

Australasian Radiology

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The purpose of this study was to establish quantification method of lactate concentration by proton magnetic resonance spectroscopy (MRS) carried out using a conventional 1.5-T MRI machine. We used a lactate phantom with known concentrations (1, 1.5, 3, 6, 12 and 14 mmol/L). As a clinical example, a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was evaluated. Proton MRS was carried out using a clinical 1.5-T super-conducting magnetic resonance whole-body system. Data were acquired by point resolved spectroscopy. A coupling constant of J = 7.35 Hz (2/J = 272 ms) and two long in-phase echo time of 272 ms and 544 ms were used to calculate the T2 relaxation time. The tissue water signal was used as an internal standard to quantify lactate. The correlation coefficient R between the calculated lactate concentrations and the known concentration of lactate was 0.99 with a constant factor of 0.32 (1/3.14). In patients with MELAS, the lactate concentration measured by MRS was 6.2 mmol/kg wet weight, which is similar to the value obtained in previous studies. In the present study, we have established a reliable method for lactate quantification in a phantom study and have shown a sample of clinical case of MELAS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lactate quantification by proton magnetic resonance spectroscopy using a clinical MRI machine: A basic study

Isobe

Matsumura

Anno

et al. 2007

Australasian Radiology

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“…LOCALIZED IN VIVO nuclear magnetic resonance (NMR) spectroscopy allows investigation of specific metabolites in situ, and extends morphologic information provided by imaging modalities. Combined magnetic resonance imaging (MRI) and spectroscopy (MRS) has developed to a stage that enables routine studies of the neonatal brain in a clinical environment (1–4). For 1 H spectroscopy, protocols for absolute quantitation of metabolite concentrations have been proposed that utilize the tissue water signal as the internal concentration reference (5–7).…”

mentioning

confidence: 99%

Proton spectroscopic metabolite signal relaxation times in preterm infants: A prerequisite for quantitative spectroscopy in infant brain

Kugel¹,

Roth²,

Pillekamp³

et al. 2003

Magnetic Resonance Imaging

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Purpose: To determine relaxation times of metabolite signals in proton magnetic resonance (MR) spectra of immature brain, which allow a correction of relaxation that is necessary for a quantitative evaluation of spectra acquired with long TE. Proton MR spectra acquired with long TE allow a better definition of metabolites as N-acetyl aspartate (NAA) and lactate especially in children. Materials and Methods:Relaxation times were determined in the basal ganglia of 84 prematurely born infants at a postconceptional age of 37.8 Ϯ 2.2 (mean Ϯ SD) weeks. Metabolite resonances were investigated using the doublespin-echo volume selection method (PRESS) at 1.5 T. T1 was determined from intensity ratios of signals obtained with TRs of 1884 and 6000 msec, measured at 3 TEs (25 msec, 136 msec, 272 msec). T2 was determined from signal intensity ratios obtained with TEs of 136 msec and 272 msec, measured at 2 TR. Taking only long TEs reduced baseline distortions by macromolecules and lipids. For myo-inositol (MI), an apparent T2 for short TE was determined from the ratio of signals obtained with TE ϭ 25 msec and 136 msec. Intensities were determined by fitting a Lorentzian to the resonance, and by integration.Results: Relaxation times were as follows: trimethylaminecontaining compounds (Cho): T1 ϭ 1217 msec/T2 ϭ 273 msec; total creatine (Cr) at 3.9 ppm: 1010 msec/111 msec; Cr at 3.0 ppm: 1388 msec/224 msec; NAA: 1171 msec/499 msec; Lac: 1820 msec/1022 msec; MI: 1336 msec/173 msec; apparent T2 at short TE: 68 msec.Conclusion: T1 and T2 in the basal ganglia of premature infants do not differ much from previously published data from basal ganglia of older children and adults. T2 of Cho was lower than previous values. T2 of Cr at 3.9 ppm and Lac have been measured under different conditions before, and present values differ from these data. LOCALIZED IN VIVO nuclear magnetic resonance (NMR) spectroscopy allows investigation of specific metabolites in situ, and extends morphologic information provided by imaging modalities. Combined magnetic resonance imaging (MRI) and spectroscopy (MRS) has developed to a stage that enables routine studies of the neonatal brain in a clinical environment (1-4). For 1 H spectroscopy, protocols for absolute quantitation of metabolite concentrations have been proposed that utilize the tissue water signal as the internal concentration reference (5-7). In general, the determination of metabolite concentrations from MR spectra requires correction for relaxation or saturation. These effects can be minimized using short TE and long TR, but with common volume selection methods, there is a remaining error due to signal decay during the nonzero TE. Shorter TR may be necessary to allow sufficient averaging when measuring small volumes. In short TE, spectra signal area determination of metabolites is complicated-especially in small infants-due to macromolecules distorting the baseline, a high glutamine/ glutamate signal partially masking the small N-acetyl aspartate (NAA) signal, and lipids masking lactate (Lac...

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“…High resolution 3D T1 weighted gradient echo (time of relaxation [TR]: 30 msec; echo time [TE]: 7 msec; voxel size: 0.680.68 Â 1.1 mm) and T2 weighted fast spin echo imaging (TR: 5640 msec; TE: 95 msec; echo train length: 16; voxel size: 1 mm Â 1 mm Â 3 mm) were prepared for basic anatomic evaluations. Single voxel proton MR spectroscopy (MRS; TR: 1500 msec; TE: 144 msec; voxel size: 1.5 cm Â 1.5 cm Â 1.5 cm) was performed, voxels were placed to the deep gray matter of the basal ganglia [Kugel et al, 1998;Thayyil et al, 2010]. The diffusion tensor measurement (TR: 7500 msec; TE: 106 msec; b factor: 1,000; voxel size: 1 mm Â 1 mm Â 3.3 mm; motion probing gradient: 25) was quantified by calculating secondary grayscale images that allow visual inspection and analysis of diffusion-related parameters.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Blepharophimosis mental retardation syndrome Say‐Barber/Biesecker/Young‐Simpson type – New findings with neuroimaging

Szakszon

Berényi

Jakab

et al. 2011

American J of Med Genetics Pt A

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We report on a female patient with blepharophimosis mental retardation syndrome of Say/Barber/Biesecker/Young-Simpson (SBBYS) type. Main findings in her were marked developmental delay, blepharophimosis, ptosis, cleft palate, external auditory canal stenosis, small and malformed teeth, hypothyroidism, hearing impairment, and joint limitations. We performed diffusion tensor magnetic resonance imaging (MRI) and tractography of the brain which showed inappropriate myelination and disturbed white matter integrity. Cytogenetic analysis, subtelomeric fluorescence in situ hybridization and comparative genomic hybridization failed to identify an abnormality. It remains uncertain whether the MRI findings are specific to the present patient or form part of the SBBYS syndrome.

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Proton MR Spectroscopy in Infants with Cerebral Energy Deficiency due to Hypoxia and Metabolic Disorders

Abstract: High Lac/TMA even with normal NAA/TMA in children with enzyme deficiencies, in contrast to Lac/TMA that correlates with clinical grade and low NAA/TMA in asphyxic children, hints at different mechanisms of cell damage in the two disease groups.

Cited by 9 publications

References 26 publications

Lactate quantification by proton magnetic resonance spectroscopy using a clinical MRI machine: A basic study

Lactate quantification by proton magnetic resonance spectroscopy using a clinical MRI machine: A basic study

Proton spectroscopic metabolite signal relaxation times in preterm infants: A prerequisite for quantitative spectroscopy in infant brain

Blepharophimosis mental retardation syndrome Say‐Barber/Biesecker/Young‐Simpson type – New findings with neuroimaging

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