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

Abstract

With protocols designed for use in a clinical environment we investigated the feasibility and diagnostic potential of (13)C MRS after 1-(13)C labeled glucose infusion. (13)C MRS brain examinations were performed in 27 subjects (17 children and pediatric patients, six adult patients, and four adult controls), using a standard 1.5 T clinical MR scanner. 1-(13)C glucose, 99% enriched (20% w/v) was administered intravenously (690 or 210 mg/kg body weight) or orally (730 mg/kg). Cerebral (13)C-enrichment patterns and time courses were compared. 1-(13)C glucose appeared in brain spectra within 2.5-15 min, with ensuing enrichment of its metabolites. No complications were encountered. When data obtained in patients were compared with controls, striking abnormalities in hepatic encephalopathy and in premature brain were observed, consistent with reduced cerebral glucose metabolism. Abnormalities in the (13)C enrichment pattern were also observed in pediatric patients with leukodystrophies and mitochondrial disorders. In this preliminary survey, we conclude that (13)C MRS in combination with glucose infusion is safe and efficient and provides new insights into the pathophysiology of brain disorders.