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A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy
Published on: May 16, 2015
Changes of positron emission tomography in newborn infants at different gestational ages, and neonatal
Yuan Shi1, Jin-Ning Zhao, Lei Liu
1Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China.
Insights
Brain glucose metabolism in infants increases with gestational age, as shown by (18)F-fluorodeoxyglucose positron emission tomography. This imaging technique also reveals altered metabolism in hypoxic-ischemic encephalopathy, with severity correlating to reduced glucose uptake.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Assessing neonatal brain development and injury is crucial for early intervention.
- Cerebral glucose metabolism is a key indicator of brain function and maturation.
- Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) is a sensitive tool for measuring metabolic activity.
Purpose of the Study:
- To investigate cerebral glucose metabolism in relation to gestational age in healthy infants.
- To evaluate cerebral glucose metabolism in newborns with hypoxic-ischemic encephalopathy (HIE).
- To explore the potential of (18)F-FDG PET for assessing brain development and injury in neonates.
Main Methods:
- (18)F-FDG PET scans were performed on 36 infants without brain injury across different gestational ages (≤32, 33-34, 35-36, ≥37 weeks).
- (18)F-FDG PET scans were also performed on 24 newborns diagnosed with HIE (mild, moderate, severe).
- Quantitative analysis of (18)F-FDG uptake was conducted to assess cerebral glucose metabolism.
Main Results:
- Cerebral glucose metabolism showed a trend of increase with advancing gestational age, with significantly higher (18)F-FDG uptake in infants ≥37 weeks compared to those ≤32 weeks (P < 0.01).
- Image clarity of cranial (18)F-FDG PET also improved with increased gestational age.
- Infants with HIE exhibited altered cerebral glucose metabolism, characterized by bilateral asymmetry or reduced uptake.
- A significant decrease in (18)F-FDG uptake was observed in severe HIE compared to mild and moderate HIE (P < 0.05).
Conclusions:
- (18)F-FDG PET imaging demonstrates that cerebral glucose metabolism matures with increasing gestational age in healthy infants.
- (18)F-FDG PET can detect significant alterations in cerebral glucose metabolism associated with the severity of neonatal hypoxic-ischemic encephalopathy.
- This imaging modality holds promise for evaluating brain development and injury in newborn infants, warranting further clinical investigation.
Abstract:
Cerebral glucose metabolism was measured by (18)F-fluorodeoxyglucose position emission tomography in infants at different gestational ages and with neonatal hypoxic-ischemic encephalopathy. Thirty-six preterm and term infants at different gestational ages without brain injury were divided into four subgroups: ≤32 weeks (n = 4), 33-34 weeks (n = 5), 35-36 weeks (n = 12), and ≥37 weeks (n = 15). Twenty-four newborn infants with hypoxic-ischemic encephalopathy were divided into three subgroups: mild (n = 13), moderate (n = 7), and severe (n = 4). Cerebral glucose metabolism manifested a trend toward increase, and the structure of cranial (18)F-fluorodeoxyglucose positron emission tomography images became clear with increased gestational age, especially at ≥37 weeks. Uptakes of (18)F-fluorodeoxyglucose in the ≥37-week group were significantly higher than in the ≤32-week group (P < 0.01). Cerebral glucose metabolism changed significantly in neonatal hypoxic-ischemic encephalopathy, and was either unbalanced bilaterally or relatively low at all sites. Moreover, uptakes of (18)F-fluorodeoxyglucose were significantly lower in severe than in mild and medium hypoxic-ischemic encephalopathy (P < 0.05). Cerebral glucose metabolism, as measured by (18)F-fluorodeoxyglucose positron emission tomography, may prove useful for estimating brain development and injury in newborn infants, and its clinical values need further investigation.
