EARLY CEREBRAL PROTON MRS AND NEURODEVELOPMENTAL OUTCOME IN INFANTS WITH CYSTIC LEUKOMALACIA

The present study tested the hypothesis that proton magnetic resonance spectroscopy (H-1-MRS) predicted neurodevelopmental outcome in infant s with cystic leukomalacia (CL), Nineteen infants with CL (grade 2, N= 7; grade 3, N=7; grade 4, N=5), graded according to the authors' class ification, were examined at corrected ages of mean 1.5+/-2.1 SD weeks. H-1-MRS of the basal ganglia and the periventricular white matter was performed, Two infants died, 16 had an adverse neurodevelopmental out come and one was normal at follow-up, N-acetylaspartate (NAA):choline (Cho) ratios were mean 1.12+/-0.19 (SD) (grade 2), mean 0.95+/-0.11 (S D) (grade 3), and mean 0.01+/-0.13 (SD) (grade 4), These differences a re significant (P<0.01, ANOVA), NAA:Cho ratios showed a positive corre lation with developmental quotient (DQ) at the age of greater than or equal to 1 year (P<0.05), In 13 infants lactate (Lac) was found, Lac:N AA ratios showed a negative correlation with NAA:Cho ratios, but not w ith Do, We conclude that a low NAA:Cho ratio predicted a poor outcome, whereas some infants developed unfavourably despite a normal NAA:Cho ratio, We speculate that partial volume effects might explain this obs ervation.