Diagnostic and prognostic value of cerebral 31P magnetic resonance spectroscopy in neonates with perinatal asphyxia.

Détails

ID Serval
serval:BIB_F981FA9407BB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Diagnostic and prognostic value of cerebral 31P magnetic resonance spectroscopy in neonates with perinatal asphyxia.
Périodique
Pediatric research
Auteur(s)
Martin E., Buchli R., Ritter S., Schmid R., Largo R.H., Boltshauser E., Fanconi S., Duc G., Rumpel H.
ISSN
0031-3998
Statut éditorial
Publié
Date de publication
1996
Peer-reviewed
Oui
Volume
40
Numéro
5
Pages
749-58
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Résumé
The impact of depressed neonatal cerebral oxidative phosphorylation for diagnosing the severity of perinatal asphyxia was estimated by correlating the concentrations of phosphocreatine (PCr) and ATP as determined by magnetic resonance spectroscopy with the degree of hypoxic-ischemic encephalopathy (HIE) in 23 asphyxiated term neonates. Ten healthy age-matched neonates served as controls. In patients, the mean concentrations +/- SD of PCr and ATP were 0.99 +/- 0.46 mmol/L (1.6 +/- 0.2 mmol/L) and 0.99 +/- 0.35 mmol/L (1.7 +/- 0.2 mmol/L), respectively (normal values in parentheses). [PCr] and [ATP] correlated significantly with the severity of HIE (r = 0.85 and 0.9, respectively, p < 0.001), indicating that the neonatal encephalopathy is the clinical manifestation of a marred brain energy metabolism. Neurodevelopmental outcome was evaluated in 21 children at 3, 9, and 18 mo. Seven infants had multiple impairments, five were moderately handicapped, five had only mild symptoms, and four were normal. There was a significant correlation between the cerebral concentrations of PCr or ATP at birth and outcome (r = 0.8, p < 0.001) and between the degree of neonatal neurologic depression and outcome (r = 0.7). More important, the outcome of neonates with moderate HIE could better be predicted with information from quantitative 31P magnetic resonance spectroscopy than from neurologic examinations. In general, the accuracy of outcome predictability could significantly be increased by adding results from 31P magnetic resonance spectroscopy to the neonatal neurologic score, but not vice versa. No correlation with outcome was found for other perinatal risk factors, including Apgar score.
Mots-clé
Asphyxia Neonatorum, Brain, Energy Metabolism, Follow-Up Studies, Humans, Infant, Infant, Newborn, Magnetic Resonance Spectroscopy, Neurologic Examination, Phosphorus Isotopes, Prognosis, Risk Factors
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/01/2008 11:06
Dernière modification de la notice
20/08/2019 17:25
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