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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

MR Spectroscopy of the Fetal Brain: Is It Possible without Sedation?

V. Berger-Kulemann, P.C. Brugger, D. Pugash, M. Krssak, M. Weber, A. Wielandner and D. Prayer
American Journal of Neuroradiology February 2013, 34 (2) 424-431; DOI: https://doi.org/10.3174/ajnr.A3196
V. Berger-Kulemann
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
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P.C. Brugger
bAnatomy and Cell Biology (P.C.B.), Medical University of Vienna, Vienna, Austria
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D. Pugash
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
cDepartment of Gynecology and Obstetrics (D.P.), Medical University of British Columbia, BC Women's Hospital, Vancouver, British Columbia, Canada.
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M. Krssak
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
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M. Weber
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
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A. Wielandner
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
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D. Prayer
aFrom the Departments of Radiology (V.B.-K., M.K., M.W., A.W., D.P.)
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    Fig 1.

    GW 29 + 6, single-voxel MR spectroscopy of the brain. PRESS with a long TE (144 ms). VOI 2.7 cm3. Cephalic presentation. Normal age-related spectrum.

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    Fig 2.

    GW 31 + 3, single-voxel MR spectroscopy of the brain. PRESS with a short TE (35 ms). VOI 2.7 cm3. Cephalic presentation. Normal age-related spectrum.

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    Fig 3.

    GW 24 + 0, single-voxel MR spectroscopy of the brain. PRESS with a long TE (144 ms). VOI 2.7 cm3. Cephalic presentation. Distinct peak in the lactate region in a fetus with a brain tumor.

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    Fig 4.

    GW 31 + 3, single-voxel MR spectroscopy of the brain. PRESS with a short TE (35 ms). VOI 2.7 cm3. Breech presentation. Peak in the lipid/Lac region. No fetal pathology was found. In this case, a premature rupture of the membranes was present and indications of maternal infection, which confirmed the decision to perform a cesarean delivery. Notice the reduced amniotic fluid on the scout scans.

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    Fig 5.

    A–C, The linear correlation analysis confirmed the significant increase of NAA/Cr ratio and shows a not significant decrease of Cho/Cr and mIns/Cr ratios with GA in the readable short TE spectra of normally developed fetuses. D and E, Note the increase of the NAA/Cr ratio and the decrease of the Cho/Cr ratio with GA in the readable long TE spectra of normally developed fetuses.

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    Fig 6.

    Lactate signals found in readable spectra with long and short TEs of normally and pathologically developed fetuses.

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    Table 1:

    Fetal pathologies of readable and nonreadable spectra with short TEs

    Short TEs (35 ms)
    Readable
        Zellweger syndrome
        Solitary median maxillary central incisor
        Infratentorial neoplasm
        IUGR
        Abdominal mass
        Cerebral edema
        Congenital diaphragmatic hernia
        Microphthalmos
        Gastroschisis
    Nonreadable
        Ovarian cyst
        Congenital cystic adenomatoid malformation
        Abdominal mass
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    Table 2:

    Fetal pathologies of readable and nonreadable spectra with long TEs

    Long TEs (144 ms)
    Readable
        Corpus callosum agenesia
        Infratentorial mass
        IUGR
        Chiari II malformation
        Asymmetric ventricles
        Cerebral ischemia
        Bilateral cheilognathopalatoschisis
        Cerebral arteriovenous fistula
        Lung hypoplasia
        Kidney agenesia
        Intracranial teratoma
    Nonreadable
        Vitium cordis
        Congenital diaphragmatic hernia
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American Journal of Neuroradiology: 34 (2)
American Journal of Neuroradiology
Vol. 34, Issue 2
1 Feb 2013
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Cite this article
V. Berger-Kulemann, P.C. Brugger, D. Pugash, M. Krssak, M. Weber, A. Wielandner, D. Prayer
MR Spectroscopy of the Fetal Brain: Is It Possible without Sedation?
American Journal of Neuroradiology Feb 2013, 34 (2) 424-431; DOI: 10.3174/ajnr.A3196

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MR Spectroscopy of the Fetal Brain: Is It Possible without Sedation?
V. Berger-Kulemann, P.C. Brugger, D. Pugash, M. Krssak, M. Weber, A. Wielandner, D. Prayer
American Journal of Neuroradiology Feb 2013, 34 (2) 424-431; DOI: 10.3174/ajnr.A3196
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