Temporal and anatomical variations of brain water apparent diffusion coefficient in perinatal cerebral hypoxic-ischemic injury: Relationships to cerebral energy metabolism
✍ Scribed by Dr. John S. Thornton; Roger J. Ordidge; Juliet Penrice; Ernest B. Cady; Philip N. Amess; Shonit Punwani; M. Clemence; J. S. Wyatt
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 838 KB
- Volume
- 39
- Category
- Article
- ISSN
- 0740-3194
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Cerebral apparent diffusion coefficients {ADCs) were determined in nine newborn piglets before and for 48 h after transient hypoxia‐ischemia. Phosphorus MRS revealed severely reduced cerebral energy metabolism during the insult and an apparently complete recovery 2 h after resuscitation commenced. At this time, mean ADC over the imaging slice (ADC~global~) was 0.88 (0.04) × 10^9^ m^2^ · s^1^ (mean (SD}), which was close to the baseline value of 0.92 (0.4) × 10^9^ m^2^ · s^1^. In seven of the animals, a “secondary” failure of energy metabolism then evolved, accompanied by a decline in ADC~global~ to 0.64 (0.17) × 10^9^ m^2^ · s^1^ at 46 h postresuscitation (P < 0.001 versus baseline). For these seven animals, ADC~global~ correlated linearly with the concentration ratio [phosphocreatine (PCr)][inorganic phosphate (Pi)] (0.94 r < 0.99; P > 0.001). A nonlinear relationship was demonstrated between ADC~global~, and the concentration ratio [nucleotide triphosphate (NTP)]/ [Pi + PCr + 3 NTP]. The ADC reduction commenced in the parasagittal cortex before spreading in a characteristic pattern throughout the brain. ADC seems to be closely related to cerebral energy status and shows considerable potential for the assessment of hypoxic‐ischemic injury in the newborn brain.