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1‐ 13 C glucose magnetic resonance spectroscopy of pediatric and adult brain disorders
Author(s) -
Blüml Stefan,
Moreno Angel,
Hwang JongHee,
Ross Brian D.
Publication year - 2001
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.679
Subject(s) - medicine , encephalopathy , pathophysiology , carbohydrate metabolism , in vivo magnetic resonance spectroscopy , central nervous system , magnetic resonance imaging , endocrinology , nuclear medicine , radiology
With protocols designed for use in a clinical environment we investigated the feasibility and diagnostic potential of 13 C MRS after 1‐ 13 C labeled glucose infusion. 13 C MRS brain examinations were performed in 27 subjects (17 children and pediatric patients, six adult patients, and four adult controls), using a standard 1.5 T clinical MR scanner. 1‐ 13 C glucose, 99% enriched (20% w/v) was administered intravenously (690 or 210 mg/kg body weight) or orally (730 mg/kg). Cerebral 13 C‐enrichment patterns and time courses were compared. 1‐ 13 C glucose appeared in brain spectra within 2.5–15 min, with ensuing enrichment of its metabolites. No complications were encountered. When data obtained in patients were compared with controls, striking abnormalities in hepatic encephalopathy and in premature brain were observed, consistent with reduced cerebral glucose metabolism. Abnormalities in the 13 C enrichment pattern were also observed in pediatric patients with leukodystrophies and mitochondrial disorders. In this preliminary survey, we conclude that 13 C MRS in combination with glucose infusion is safe and efficient and provides new insights into the pathophysiology of brain disorders. Copyright © 2001 John Wiley & Sons, Ltd. Abbreviations used: Ala alanineALD adrenoleukodystrophyAsp aspartateCACH childhood ataxia with diffuse central nervous system hypomyelinationGlc glucoseGln glutamineGlu glutamate, HE, hepatic encephalopathyHCO 3 − bicarbonatei.v. intravenousLac lactatemI myo‐inositolNAA N‐acetylaspartateTCA tricarboxylic acid.