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Temporal and anatomical variations of brain water apparent diffusion coefficient in perinatal cerebral hypoxic‐ischemic injury: Relationships to cerebral energy metabolism
Author(s) -
Thornton John S.,
Ordidge Roger J.,
Penrice Juliet,
Cady Ernest B.,
Amess Philip N.,
Punwani Shonit,
Clemence M.,
Wyatt J. S.
Publication year - 1998
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.1910390609
Subject(s) - phosphocreatine , effective diffusion coefficient , ischemia , cerebral cortex , hypoxia (environmental) , energy metabolism , resuscitation , medicine , cortex (anatomy) , cerebral blood flow , cardiology , nuclear medicine , anesthesia , endocrinology , chemistry , biology , magnetic resonance imaging , oxygen , neuroscience , radiology , organic chemistry
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.