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279 PROTON MAGNETIC RESONANCE SPECTROSCOPY AT TERM AGE IS NOT PREDICTIVE OF NEURODEVELOPMENTAL OUTCOME IN VERY LOW BIRTH WEIGHT PRETERM INFANTS.
  1. E. M. Van Brussel#,
  2. M. Mirmiran,
  3. D. M. Spielman*,
  4. P. D. Barnes*,
  5. T. L. Sutcliffe,
  6. J. D. Dermon**,
  7. R. L. Ariagno1
  1. Departments of Pediatrics
  2. *Radiology
  3. **School of Medicine, Stanford University, Stanford, CA
  4. #Mayo Clinic College of Medicine, Rochester, MN

Abstract

Background Proton magnetic resonance spectroscopy (MRS) has been shown to predict neurodevelopmental outcome in term, asphyxiated newborns scanned at term age.

Objective The purpose of this retrospective study was to evaluate if near-term MRS predicted neurodevelopmental outcome at 18-24 mo in VLBW preterm infants.

Methods Thirty-six infants, BWt ≤ 1,510 g, GA ≤ 32 wk, were scanned between 35 and 43 wk postmenstrual age. They were assessed at 18-24 mo by the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development II. Based on their scores, they were divided into 2 outcome groups for each index, normal (≥ 85) and abnormal (< 85). MRS was performed on a 1.5 Tesla GE Healthcare scanner. Metabolite spectra were analyzed in 2 regions of interest: (1) combined left and right thalamus and basal ganglia and (2) left and right cortex. Choline and choline-containing compounds (Ch), creatine and phosphocreatine (Cr), and N-acetylaspartate (NAA) peaks were integrated and ratios of Ch/Cr, NAA/Cr, and NAA/Ch were calculated. This study was approved by the Panel on Human Subjects in Medical Research at Stanford.

Results Based on the MDI, 24 (67%) infants were classified as normal and 12 (33%) as abnormal. Based on the PDI, 26 (76%) infants were classified as normal and 8 (24%) as abnormal. Unpaired t-tests did not demonstrate a statistically significant difference in Ch/Cr, NAA/Cr, or NAA/Ch between infants with normal and abnormal developmental outcome.

Conclusion Near-term MRS did not predict neurodevelopmental outcome in VLBW preterm infants at 18-24 mo in contrast to reports of term infants studied near birth with asphyxia. Longitudinal studies in VLBW infants are needed to assess if abnormal developmental changes in MRS are seen in infants who are at risk for later abnormal outcome.

Acknowledgment EMV was a summer medical student research awardee from the American Pediatric Society and Society for Pediatric Research.

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