Background: Pediatric patients with cyanotic congenital heart disease (CCHD) may show structural and metabolic changes in the brain. Magnetic resonance spectroscopy (MRS) is an analytical application of magnetic resonance imaging (MRI) that enables the identification and quantification of metabolites. This study was to determine metabolic changes in the brain through MRS patterns (N-acetylaspartate/Choline ratio and lactate) in patients with diagnosed cyanotic congenital heart disease and its correlation with the hematocrit level.
Method: This was a cross-sectional, analytic study. Newborn to 10 years old patients diagnosed with cyanotic congenital heart disease were recruited in the OPD Pediatric Cardiology section of the Philippine Heart Center from September 2014 to January 2015. Patients from a related research which spanned from November 2015 to May 2016 were also included. Participants underwent MRI scan using 1.5 Tesla Phillips MRI scanner with magnetic resonance spectroscopy (MRS) software application. Complete blood count examination was done to determine the hematocrit level.
Results: Data gathered established that there is direct association between NAA/Cho ratio and hematocrit level in the right cerebral hemisphere (p-value of 0.9465 and Spearman's r of 0.0156), while there is inverse association in the left cerebral hemisphere (p-value of 0.2897 and Spearman's r of -0.2424). Weak correlation is noted between lactate and hematocrit levels in the right cerebral hemisphere with Spearman's r of 0.2145 and p-value of 0.3505, while strong correlation is seen in the left cerebral hemisphere as indicated by Spearman's r of 0.6175 and p-value of 0.0029.
Conclusion: NAA/Cho ratio in correlation to hematocrit level have no relationship, while lactate level in correlation to hematocrit level showed weak correlation in the right cerebral hemisphere and strong correlation in the left cerebral hemisphere.