Cerebral metabolic disturbance in hypoxic encephalopathy: Evaluation with H-1 MR spectroscopy

Purpose: To analyze metabolic changes in the brain during hypoxic encephalopathy. Materials and methods: MR imaging (MRI) and H-1 MR spectroscopy (H-1 MRS) were performed on three patients with hypoxic encephalopathy, who had need temporary mechanical ventilation, and five healthy age-matched volunteers. Spectra were obtained from bilateral fronto- parietal gray matter and basal ganglia voxels. N-acetyl aspartate (NAA), creatine (Cr) and choline (Cho) were analyzed. Results: (1) MRI; T1 weighted MRI revealed high signal intensity areas in the diffuse cerebral cortex and basal ganglia in two patients. The former was thought to reflect cortical laminar necrosis. T2 weighed MRI showed high signal intensity in diffuse white matter. (2) H-1 MRS; significant reduction of the NAA/Cr ratio and elevation of the Cho/Cr ratio were detected. Conclusion: H-1 MRS is able to quantify metabolic alterations in the hypoxic encephalopathy.