J Korean Pediatr Soc.
2001 May;44(5):533-545.
Neuro-developmental Assessment of Patients with Transposition of the Great Arteries by Localized 1H-Magnetic Resonance Spectroscopy
- Affiliations
-
- 1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine.
- 2Department of Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine.
- 3NMR Laboratory, Asan Institute for Life Sciences.
- 4Department of Pediatrics, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Abstract
-
PURPOSE: The purpose of this study was to evaluate the hemodynamic effect of transposition of
the great arteries(TGA) on neuro-development by measuring the cerebral metabolites before and 1
year after open heart surgery(OHS) by localized in vivo 1H-magnetic resonance spectroscopy(1H-
MRS) along with Bayley scales of infants development II(BSID II).
METHODS
Full-term newborns(N=13) with TGA and intact ventricular septum were examined 1H-MRS before OHS. Follow-up MRS and neuro-developmental examination by BSID II were performed in 9 patients at 12 months of age. Normal newborns(N=22) and infants(N=13, ages=9- 36 months) were included for comparison. Image guided STEAM-spectra were obtained from the parietal white matter(PWM) and occipital gray matter(OGM) regions with proton brain examina tion(PROBE). All spectroscopic raw data were processed and the values of the NAA/Cr, Cho/Cr, mI/Cr and NAA/Cho ratios were calculated.
RESULTS
The Values of NAA/Cr and NAA/Cho were lower in PWM and OGM, and Cho/Cr and mI/ Cr were higher in OGM from infants with TGA than from normal infants, suggesting that the abnor mal hemodynamics of TGA in fetal life may have influenced neuro-development. The follow-up MRS examinations conducted at 12 months also showed high Cho/Cr and low NAA/Cho in PWM. All abnor mal metabolite ratios from OGM in TGA newborns were normalized by 12 months. The results of BSID II showed relatively delayed mental development, especially language area than psychomotor development.
CONCLUSION
The cerebral metabolism in infants with TGA has already been damaged prior to OHS and was not normalized by 12 months. However, the exact cause of the impaired metabolism is still not yet determined from this study; it may be due to the prenatal relative hypoxemia of the brain or OHS itself.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The Findings of 1H Magnetic Resonance Spectroscopy in Children with Mental Retardation or Autism
- Analysis of 1H Magnetic Resonance Spectroscopy Pattern in Invasive Ductal Carcinoma of Breast
- Localized, water-suppressed in vivo H MR spectroscopy of human brain tumors: Preliminary results
- Transposition of the Great Arteries: Historical Background
- Usefulness of 1H Magnetic Resonance Spectroscopy for Evaluation of Cognitive Impairment after Subarachnoid Hemorrhage Caused by Rupture of Middle Cerebral Artery Aneurysm
