Antenatal proton MR spectroscopy of the human brain in vivo
Abstract
Introduction
The assessment of metabolites in the human fetal brain in utero could have diagnostic value. We explored the feasibility and potentials of proton magnetic resonance spectroscopy (1H MRS) for this purpose.
Results
1H MRS was successfully performed in the third trimester of pregnancy without using sedation. Signals for inositol, choline, creatine, and N-acetylasparatate (NAA) compounds were detected in MR spectra from single voxels in the brain. Absolute tissue levels of these metabolites resemble values measured in preterm and term babies, especially of relatively more mature brain regions, from which most of the MR spectra have been obtained. Brain maturation between 30 and 41 weeks of gestation was most clearly reflected by increasing levels of the neuronal marker NAA.
Conclusion
With proper care for the methodological aspects, antenatal 1H MRS clearly has the potential to evolve into a clinical tool for assessing a number of key metabolites in the human fetal brain in utero.
Keywords
Human fetal brain MR spectroscopy Metabolism MaturationNotes
Acknowledgements
We thank D. Klomp for technical assistance, Drs. A.J. van Bergh and R. Nijland for their contributions to this work, and the Dutch Brain Foundation for support.
References
- 1.Fenton BW, Lin CS, Macedonia C, Schellinger D, Ascher S (2001) The fetus at term: in utero volume-selected proton MR spectroscopy with a breath-hold technique—a feasibility study. Radiology 219:563–566PubMedGoogle Scholar
- 2.Heerschap A, van den Berg PP (1994) Proton magnetic resonance spectroscopy of the human fetal brain. Am J Obstet Gynecol 170:1150–1151PubMedGoogle Scholar
- 3.Kok RD, van den Bergh AJ, Heerschap A, Nijland R, van den Berg PP (2001) Metabolic information from the human fetal brain obtained with proton magnetic resonance spectroscopy. Am J Obstet Gynecol 185:1011–1015CrossRefPubMedGoogle Scholar
- 4.Kok RD, van den Berg PP, van den Bergh AJ, Nijland R, Heerschap A (2002) Maturation of the human fetal brain as observed by 1H MR spectroscopy. Magn Reson Med 48:611–616CrossRefPubMedGoogle Scholar
- 5.Kok RD, Steegers-Theunissen RP, Eskes TK, Heerschap A, van den Berg PP (2003) Decreased relative tissue levels of inositol in fetal hydrocephalus. Am J Obstet Gynecol 188:978–980CrossRefPubMedGoogle Scholar
- 6.Kreis R, Ernst T, Ross BD (1993) Development of the human brain: in vivo quantification of metabolite and water content with proton magnetic resonance spectroscopy. Magn Reson Med 30:424–437PubMedGoogle Scholar
- 7.Kreis R, Hofmann L, Boesch C, Bossi E, Huppi PS (2002) Brain metabolite composition during early human brain development as measured by quantitative in vivo 1H magnetic resonance spectroscopy. Magn Reson Med 48:949–958CrossRefPubMedGoogle Scholar
- 8.Nakada T, Kwee IL, Suzuki N, Houkin K (1989) Intrauterine fetal brain NMR spectroscopy: 1H and 31P studies in rats. Magn Reson Med 12:172–180PubMedGoogle Scholar
- 9.Ross B, Bluml S (2001) Magnetic resonance spectroscopy of the human brain. Anat Rec (New Anat) 265:54–84CrossRefGoogle Scholar
- 10.Van Cappellen van Walsum AM, Heerschap A, Nijhuis JG, Oeseburg B, Jongsma HW (1999) Hypoxia, the subsequent systemic metabolic acidosis, and their relationship with cerebral metabolite concentrations: an in vivo study in fetal lambs with proton magnetic resonance spectroscopy. Am J Obstet Gynecol 181:1537–1545PubMedGoogle Scholar