Proton magnetic resonance spectroscopy assessment of neonatal brain metabolism during cardiopulmonary bypass surgery.
Proton magnetic resonance spectroscopy assessment of neonatal brain metabolism during cardiopulmonary bypass surgery.
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在此，我们报告了强大的 3-T 单体素质子磁共振波谱 (1H MRS) 实验方案和数据分析流程的开发和性能，用于量化新生猪模型中心肺旁路 (CPB) 手术期间的脑代谢，总体目标是阐明与这些手术相关的脑损伤的主要机制。具体目标是评估哪些代谢过程可以通过 3-T 临床扫描仪上的 1H MRS 可靠地进行询问，并在深低温心脏骤停 (DHCA) 手术和恢复期间提供脑代谢的初步评估。 14 只新生猪接受了 CPB 手术，同时放置在 3-T MRI 扫描仪中，在高血糖、正常血糖和低血糖条件下进行 18、28 和 37°C DHCA 研究。总成像时间，包括基线测量、停循环 (CA) 和恢复，平均每只动物 3 小时，在此期间从 2.2 cc 右中脑体素获取 30-40 个单体素 1H MRS 光谱（sLASER 脉冲序列，TR/TE = 2000/30 ms，64 或 128 个平均值）。 3 T 的 1H MRS 能够可靠地量化 (1) CA 期间通过脑葡萄糖消耗和相关乳酸积累进行的无氧代谢，(2) CA 期间磷酸肌酸 (PCr) 到肌酸 (Cr) 的转化以及随后再灌注后的恢复，(3) CA 后恢复期间谷氨酰胺与谷氨酸 (Gln/Glu) 比率的强劲增加，以及 (4) 水峰的扩大在CA期间。 3 T 体内 1H MRS 可以可靠地量化以前被认为难以探究的细微代谢脑变化，包括即使在低血糖条件下的脑葡萄糖浓度、通过 PCr 转化为 Cr 的 ATP 使用以及 Glu 和 Gln 的差异变化。新生猪模型体外循环手术期间观察到的代谢变化为预防神经元损伤的可能机制提供了新的见解。
Here, we report on the development and performance of a robust 3-T single-voxel proton magnetic resonance spectroscopy (1H MRS) experimental protocol and data analysis pipeline for quantifying brain metabolism during cardiopulmonary bypass (CPB) surgery in a neonatal porcine model, with the overall goal of elucidating primary mechanisms of brain injury associated with these procedures. The specific aims were to assess which metabolic processes can be reliably interrogated by 1H MRS on a 3-T clinical scanner and to provide an initial assessment of brain metabolism during deep hypothermia cardiac arrest (DHCA) surgery and recovery. Fourteen neonatal pigs underwent CPB surgery while placed in a 3-T MRI scanner for 18, 28, and 37° C DHCA studies under hyperglycemic, euglycemic, and hypoglycemic conditions. Total imaging times, including baseline measurements, circulatory arrest (CA), and recovery averaged 3 h/animal, during which 30–40 single-voxel 1H MRS spectra (sLASER pulse sequence, TR/TE = 2000/30 ms, 64 or 128 averages) were acquired from a 2.2-cc right midbrain voxel. 1H MRS at 3 T was able to reliably quantify (1) anaerobic metabolism via depletion of brain glucose and the associated build-up of lactate during CA, (2) phosphocreatine (PCr) to creatine (Cr) conversion during CA and subsequent recovery upon reperfusion, (3) a robust increase in the glutamine-to-glutamate (Gln/Glu) ratio during the post-CA recovery period, and (4) a broadening of the water peak during CA. In vivo 1H MRS at 3 T can reliably quantify subtle metabolic brain changes previously deemed challenging to interrogate, including brain glucose concentrations even under hypoglycemic conditions, ATP usage via the conversion of PCr to Cr, and differential changes in Glu and Gln. Observed metabolic changes during CPB surgery of a neonatal porcine model provide new insights into possible mechanisms for prevention of neuronal injury.
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影响因子：
6.3
作者：
Dadsetan, Sherry;Kukolj, Eva;Waagepetersen, Helle S.
通讯作者：
Waagepetersen, Helle S.
影响因子：
6
作者：
Hanley, Frank L.;Ito, Hiroki;Gu, Meng;Hurd, Ralph;Riemer, R. Kirk;Spielman, Daniel
通讯作者：
Spielman, Daniel
影响因子：
4.6
作者：
Leshnower, Bradley G.;Rangaraju, Srikant;Chen, Edward P.
通讯作者：
Chen, Edward P.
DOI：
10.1046/j.1365-2257.2003.00484.x
发表时间：
2003-02-01
期刊：
CLINICAL AND LABORATORY HAEMATOLOGY
影响因子：
--
作者：
Kayiran, SM;Özbek, N;Gürakan, B
通讯作者：
Gürakan, B
低体温循环停止或低流量心肺旁路心脏手术后儿童的发育和神经状况
影响因子：
158.5
作者：
BELLINGER, DC;JONAS, RA;NEWBURGER, JW
通讯作者：
NEWBURGER, JW