Magnetic Resonance Spectroscopy (MRS) is an important imaging adjunct for the diagnosis of hypoxic ischemic injury and brain death. As the concentration of adenosine triphosphate is depleted, the cell switches from oxidative phosphorylation to anaerobic glycolysis. The byproduct of this metabolic pathway is the creation of lactate from pyruvate. This leads to lactic acidosis, which can be detected with MRS. The presence of a lactate peak on MRS is not specific to the degree of hypoxic injury. In hypoxic conditions, other metabolites are detectable by MRS such as Alanine. Alanine is a product of the glucose-alanine cycle, where Pyruvate is converted to Alanine. We hypothesize the presence of high level of Alanine is seen only in severe hypoxia, and therefore may be a more specific marker for severe HIE and brain death.
SPR 2023 Annual Meeting & Postgraduate Course