Assessment of normal fetal brain maturation in utero by proton magnetic resonance spectroscopy

Cerebral maturation in the normal human fetal brain was investigated by in utero localized proton MR spectroscopy (1H MRS). Fifty‐eight subjects at 22–39 weeks of gestational age (GA) were explored. A combination of anterior body phased‐array coils (four elements) and posterior spinal coils (two to three elements) was used. Four sequences were performed (point‐resolved spectroscopy (PRESS) sequence with short and long TEs (30 and 135 ms), with and without water saturation). A significant reduction in myo‐inositol (myo‐Ins) and choline (Cho) levels, and an increase in N‐acetylaspartate (NAA) and creatine (Cr) content were observed with progressing age. A new finding is the detection of NAA as early as 22 weeks of GA. This result is probably related to the fact that oligodendrocytes (whether mature or not) express NAA, as demonstrated by in vitro studies. Cho and myo‐inositol were the predominant resonances from 22 to 30 weeks and decreased gradually, probably reflecting the variations in substrate needed for membrane synthesis and myelination. The normal MRS data for the second trimester of gestation (when fetal MRI is usually performed) reported here can help determine whether brain metabolism is altered or not, especially when subtle anatomic changes are observed on conventional images. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.