1-C-13 glucose magnetic resonance spectroscopy of pediatric and adult brain disorders

With protocols designed for use in a clinical environment we investigated t he feasibility and diagnostic potential of C-13 MRS after 1-C-13 labeled gl ucose infusion. C-13 MRS brain examinations were performed in 27 subjects ( 17 children and pediatric patients, six adult patients, and four adult cont rols), using a standard 1.5 T clinical MR scanner. 1-C-13 glucose, 99% enri ched (20% w/v) was administered intravenously (690 or 210 mg/kg body weight ) or orally (730 mg/kg). Cerebral C-13-enrichment patterns and time courses were compared. 1-C-13 glucose appeared in brain spectra within 2.5-15 min, with ensuing enrichment of its metabolites. No complications were encounte red. When data obtained in patients were compared with controls, striking a bnormalities in hepatic encephalopathy and in premature brain were observed , consistent with reduced cerebral glucose metabolism. Abnormalities in the C-13 enrichment pattern were also observed in pediatric patients with leuk odystrophies and mitochondrial disorders. In this preliminary survey, we co nclude that C-13 MRS in combination with glucose infusion is safe and effic ient and provides new insights into the pathophysiology of brain disorders. Copyright (C) 2001 John Wiley & Sons, Ltd.