Nicola Jayne Robertson1, Stuart Faulkner1, Alan Bainbridge2, Manigandan Chandrasekaran1, Dorottya Kelen1, Sudhin Thayyil1, Ernest Cady2, Xavier Golay3, Gennadij Raivich1
1Institute for Women's Health, University College London, London, United Kingdom; 2Medical Physics & Bioengineering, University College Hospitals, London, United Kingdom; 3UCL Institute of Neurology, London, United Kingdom
1H MRS lactate/NAA is the most sensitive and specific MR biomarker of outcome following perinatal asphyxia in babies. In this validated large animal model of perinatal asphyxia we compared the rates of change of different 1H and 31P metabolite peak area ratios vs lactate/NAA during the 48 hours after a global transient hypoxic-ischaemic insult. Compared to Lac/NAA, Lac/Cr changed most rapidly and was most sensitive to lower degrees of injury while NAA/Cr, NTP/EPP and pHi/EPP were least sensitive to injury and responded last. Lac/NAA appears to provide sufficient sensitivity detect moderate to severe brain injury following global hypoxia-ischaemia.