Doppler-assessed cerebral blood flow velocity in the neonate as estimator of global cerebral blood volume flow measured using phase-contrast magnetic resonance angiography.

BACKGROUND: We hypothesized that color Doppler-measured cerebral blood flow velocity (CD-CBFV) as measured in the three feeding arteries of the brain can be used as an estimator of global cerebral blood flow. PATIENTS AND METHODS: CD-CBFV was determined as soon as possible after determination of phase-contrast magnetic resonance angiography-measured blood volume flow (PC-MRA BVF) by adding up angle-corrected time-averaged mean flow velocities of both internal carotid arteries and basilar artery. 30 newborns (gestational age ranging from 25 to 42 weeks; actual weight ranging from 1,050 to 5,858 g; postconceptional age ranging from 225 to 369 days) were investigated.
RESULTS: Doppler-determined CBFV ranged from 37 to 131 cm/s with a median of 69 cm/s. CD-CBFV showed a positive correlation with actual weight (r = 0.56, p < 0.01) and postconceptional age (r = 0.53, p < 0.01). CD-CBFV correlated positively with PC-MRA-measured BVF (r = 0.51, p < 0.01). Gestational age at birth, mechanical ventilation or gender did not influence this relationship. The limits of agreement, however, are wide, especially at higher CD-CBFV- and PC-MRA-measured BVF.
CONCLUSION: CD-CBFV may be used as a non-invasive trend-monitoring tool to detect gross changes in global cerebral blood flow in the unstable and sick neonate.