P Wintermark1, A Hansen, S K Warfield, D Dukhovny, J S Soul. 1. Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, 2300 Tupper Street, Montreal, QC H3H 1P3, Canada; Division of Newborn Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: Pia.Wintermark@bluemail.ch.
Abstract
BACKGROUND: The measurement of brain perfusion may provide valuable information for assessment and treatment of newborns with hypoxic-ischemic encephalopathy (HIE). While arterial spin labeled perfusion (ASL) magnetic resonance imaging (MRI) provides noninvasive and direct measurements of regional cerebral blood flow (CBF) values, it is logistically challenging to obtain. Near-infrared spectroscopy (NIRS) might be an alternative, as it permits noninvasive and continuous monitoring of cerebral hemodynamics and oxygenation at the bedside. OBJECTIVE: The purpose of this study is to determine the correlation between measurements of brain perfusion by NIRS and by MRI in term newborns with HIE treated with hypothermia. DESIGN/ METHODS: In this prospective cohort study, ASL-MRI and NIRS performed during hypothermia were used to assess brain perfusion in these newborns. Regional cerebral blood flow (CBF) values, measured from 1-2 MRI scans for each patient, were compared to mixed venous saturation values (SctO2) recorded by NIRS just before and after each MRI. Analysis included groupings into moderate versus severe HIE based on their initial background pattern of amplitude-integrated electroencephalogram. RESULTS: Twelve concomitant recordings were obtained of seven neonates. Strong correlation was found between SctO2 and CBF in asphyxiated newborns with severe HIE (r=0.88; p value=0.0085). Moreover, newborns with severe HIE had lower CBF (likely lower oxygen supply) and extracted less oxygen (likely lower oxygen demand or utilization) when comparing SctO2 and CBF to those with moderate HIE. CONCLUSIONS: NIRS is an effective bedside tool to monitor and understand brain perfusion changes in term asphyxiated newborns, which in conjunction with precise measurements of CBF obtained by MRI at particular times, may help tailor neuroprotective strategies in term newborns with HIE.
BACKGROUND: The measurement of brain perfusion may provide valuable information for assessment and treatment of newborns with hypoxic-ischemicencephalopathy (HIE). While arterial spin labeled perfusion (ASL) magnetic resonance imaging (MRI) provides noninvasive and direct measurements of regional cerebral blood flow (CBF) values, it is logistically challenging to obtain. Near-infrared spectroscopy (NIRS) might be an alternative, as it permits noninvasive and continuous monitoring of cerebral hemodynamics and oxygenation at the bedside. OBJECTIVE: The purpose of this study is to determine the correlation between measurements of brain perfusion by NIRS and by MRI in term newborns with HIE treated with hypothermia. DESIGN/ METHODS: In this prospective cohort study, ASL-MRI and NIRS performed during hypothermia were used to assess brain perfusion in these newborns. Regional cerebral blood flow (CBF) values, measured from 1-2 MRI scans for each patient, were compared to mixed venous saturation values (SctO2) recorded by NIRS just before and after each MRI. Analysis included groupings into moderate versus severe HIE based on their initial background pattern of amplitude-integrated electroencephalogram. RESULTS: Twelve concomitant recordings were obtained of seven neonates. Strong correlation was found between SctO2 and CBF in asphyxiated newborns with severe HIE (r=0.88; p value=0.0085). Moreover, newborns with severe HIE had lower CBF (likely lower oxygen supply) and extracted less oxygen (likely lower oxygen demand or utilization) when comparing SctO2 and CBF to those with moderate HIE. CONCLUSIONS: NIRS is an effective bedside tool to monitor and understand brain perfusion changes in term asphyxiated newborns, which in conjunction with precise measurements of CBF obtained by MRI at particular times, may help tailor neuroprotective strategies in term newborns with HIE.
Authors: Laura Biagi; Arturo Abbruzzese; Maria Cristina Bianchi; David C Alsop; Alberto Del Guerra; Michela Tosetti Journal: J Magn Reson Imaging Date: 2007-04 Impact factor: 4.813
Authors: Paul B Benni; Bo Chen; Francine D Dykes; Scott F Wagoner; Micheal Heard; April J Tanner; Teresa L Young; Khodayar Rais-Bahrami; Oswaldo Rivera; Billie L Short Journal: Adv Exp Med Biol Date: 2005 Impact factor: 2.622
Authors: Anil N Shetty; Ashley M Lucke; Peiying Liu; Magdalena Sanz Cortes; Joseph L Hagan; Zili D Chu; Jill V Hunter; Hanzhang Lu; Wesley Lee; Jeffrey R Kaiser Journal: Pediatr Radiol Date: 2018-11-06
Authors: Eva Forman; Colm R Breatnach; Stephanie Ryan; Jana Semberova; Jan Miletin; Adrienne Foran; Afif El-Khuffash Journal: Pediatr Res Date: 2017-08-02 Impact factor: 3.756
Authors: Jill B De Vis; Thomas Alderliesten; Jeroen Hendrikse; Esben T Petersen; Manon J N L Benders Journal: Pediatr Res Date: 2016-07-19 Impact factor: 3.756
Authors: Thomas Alderliesten; Jill B De Vis; Petra Ma Lemmers; Jeroen Hendrikse; Floris Groenendaal; Frank van Bel; Manon Jnl Benders; Esben T Petersen Journal: J Cereb Blood Flow Metab Date: 2016-07-20 Impact factor: 6.200
Authors: Erin M Buckley; Shyama D Patel; Benjamin F Miller; Maria Angela Franceschini; Susan J Vannucci Journal: Dev Neurosci Date: 2015-05-23 Impact factor: 2.984