Elucidating Metabolic Maturation in the Healthy Fetal Brain Using 1H-MR Spectroscopy
Elucidating Metabolic Maturation in the Healthy Fetal Brain Using 1H-MR Spectroscopy
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DOI：
10.3174/ajnr.a4512
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发表时间：
2016-02-01
影响因子：
3.5
通讯作者：
Limperopoulos, C.
中科院分区：
文献类型：
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作者：
Evangelou, I. E.;du Plessis, A. J.;Limperopoulos, C.
背景与目的：H-1-MRS为在生化水平上研究胎儿脑成熟提供了一种无创方法。本研究的目的是利用H-1-MRS来表征妊娠中期和晚期健康胎儿大脑的体内代谢成熟。材料与方法：孕周18 ~ 40周的健康孕妇志愿者接受单体素H-1-MRS检查。对运动诱发的伪影进行回顾性校正，并使用LCModel进行量化。采用线性回归检验绝对代谢物浓度与总NAA、Cr和Cho与总Cho和总Cr的比值与胎龄之间的关系。结果：从129名平均胎龄30.66.3周的孕妇中获得244个光谱。总Cho在整个胎龄保持相对稳定（r(2) = 0.04, P = 0.01）。总Cr （r(2) = 0.60, P < 0.0001）、总NAA和总NAA /总Cho （r(2) = 0.58, P < 0.0001）在18 ~ 40周显著增加，而总NAA /总Cr增加较慢（r(2) = 0.12, P < 0.0001）。总Cr /总Cho随胎龄增加（r(2) = 0.53, P < 0.0001），总Cho /总Cr随胎龄减少（r(2) = 0.52, P < 0.0001）。该队列还被分为在妊娠中期和晚期接受MRS的人群，并分别进行分析。结论：我们描述了正常胎儿大脑在妊娠中期和晚期的代谢变化，并推导了规范的代谢指标。这些参考值可用于体内胎儿脑代谢成熟的研究。
BACKGROUND AND PURPOSE: H-1-MRS provides a noninvasive way to study fetal brain maturation at the biochemical level. The purpose of this study was to characterize in vivo metabolic maturation in the healthy fetal brain during the second and third trimester using H-1-MRS.MATERIALS AND METHODS: Healthy pregnant volunteers between 18 and 40 weeks gestational age underwent single voxel H-1-MRS. MR spectra were retrospectively corrected for motion-induced artifacts and quantified using LCModel. Linear regression was used to examine the relationship between absolute metabolite concentrations and ratios of total NAA, Cr, and Cho to total Cho and total Cr and gestational age.RESULTS: Two hundred four spectra were acquired from 129 pregnant women at mean gestational age of 30.63 6 weeks. Total Cho remained relatively stable across the gestational age (r(2) = 0.04, P = .01). Both total Cr (r(2) = 0.60, P < .0001) as well as total NAA and total NAA to total Cho (r(2) = 0.58, P < .0001) increased significantly between 18 and 40 weeks, whereas total NAA to total Cr exhibited a slower increase (r(2) = 0.12, P < .0001). Total Cr to total Cho also increased (r(2) = 0.53, P < .0001), whereas total Cho to total Cr decreased (r(2) = 0.52, P < .0001) with gestational age. The cohort was also stratified into those that underwent MRS in the second and third trimesters and analyzed separately.CONCLUSIONS: We characterized metabolic changes in the normal fetal brain during the second and third trimesters of pregnancy and derived normative metabolic indices. These reference values can be used to study metabolic maturation of the fetal brain in vivo.