Abstract 1204 Poster Session II, Sunday, 5/2 (poster 76)

This study was designed to test the hypothesis that 1H MR spectroscopic values can be used to predict the neurological outcome of high risk newborn infants. Newborn infants (N=43) with gestational age of 28-43 weeks who were admitted to the NICU due to prematurity or birth asphyxia were examined. Initial MR spectroscopy was performed at their postconceptional age (PCA) of 33-43 weeks. Follow-up examinations were done 1-4 weeks after the initial examination (N=10). Infants were divided into 3 groups according to their neurodevelopmental outcomes at 8 months of PCA: for group I (n=29), normal outcome, for group II (n=4), mild neurological impairment, for group III (n=10), severe neurological impairment or death. All MR imaging and localized in vivo 1H MR spectroscopy were performed on a GE 1.5 T SIGNA system(GE). Image guided STEAM-spectra were obtained from parietal white matter with TE of 30 msec, TR of 3.0 sec, and 36 AVG with PROBE. Volumes of voxels were 7-9 ml. For each group, the values of the [NAA/Cr], and [Lac/NAA] ratios were evaluated. The [NAA/Cr] values for group I showed a steady increase as PCA increased (r=0.65), and the values for group III are lower than those of group I (p=0.05). The [Lac/NAA] values for group I were lower that those for group II & III at all PCAs. The values of [Lac/NAA] were 0.68±0.34(0.0-1.65), 1.22± 0.33(0.9-1.8), and 3.4±3.0(0.9-8.6), for groups I, II, III, respectively. The values of [Lac/NAA] greater than 2.0 which accompanies with a decreased value of [NAA/Cr] can be an early predictor for the severe neurological outcome. The values of [Lac/NAA] less than 1.0 with the normal range of [NAA/Cr] can be an early predictor for the normal neurodevelopmental outcome. We conclude that the 1H MR spectroscopic values such as [NAA/Cr] and [Lac/NAA] can be used as early predictors for the neurodevelopmental outcome.