Abstract
Cerebral blood flow (CBF) alterations are important in pathogenesis of neonatal ischemic/hemorrhagic brain damage. In clinical practice, estimation of neonatal CBF is mostly based on Doppler-measured blood flow velocities in major intracranial arteries. Using phase-contrast magnetic resonance angiography (PC-MRA), global CBF can be estimated, but there is limited neonatal experience. The objective of this study was to gain experience with PC-MRA for the determination of global CBF in neonates. In infants eligible for MRI, PC-MRA global CBF was determined by measuring volume blood flow in both internal carotid arteries (ICAs) and basilar artery (BA). Thirty newborns (GA, 25.7–42.1 wk; weight, 1050–5858 g; postconceptional age, 225–369 d) were investigated. Total PC-MRA CBF ranged from 27 to 186 mL/min. Significant correlations between PC-MRA CBF and postconceptional age and weight were detected. When calculating PC-MRA measured CBF per kilogram body weight, brain perfusion was about stable over the range of postconceptional ages and ranged between 11 and 48 mL/min/kg (median, 25 mL/min/kg). In conclusion, neonatal PC-MRA CBF seems to be a useful technique to estimate noninvasive CBF.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- BA:
-
basilar artery
- CBF:
-
cerebral blood flow
- ICA:
-
internal carotid artery
- PC-MRA:
-
phase-contrast magnetic resonance angiography
REFERENCES
Leahy FA, Sankaran K, Cates D, MacCallum M, Rigatto H 1979 Quantitative noninvasive method to measure cerebral blood flow in newborn infants. Pediatrics 64: 277–282
Volpe JJ, Herscovitch P, Perlman JM 1983 Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement. Pediatrics 72: 589–601
Frewen TC, Kissoon N, Kronick J, Fox M, Lee R, Bradwin N 1991 Cerebral blood flow, cross-brain oxygen extraction, and fontanelle pressure after hypoxic-ischemic injury in newborn infants. J Pediatr 118: 265–271
Greisen G, Pryds O 1988 Intravenous 133Xenon clearance in preterm neonates with respiratory distress. Internal validation of CBFO as a measureof global cerebral blood flow. Scand J Clin Lab Invest 48: 673–678
Ashwal S, Scheider S, Thompson J 1989 Xenon computed tomography measuring cerebral blood flow in the determination of brain death in children. Ann Neurol 25: 539–546
Tanner SF, Cornette L, Ramenghi LA, Miall LS, Ridgway JP, Smith MA, Levene MI 2003 Cerebral perfusion in infants and neonates: preliminary results obtained using dynamic susceptibility contrast enhanced magnetic resonance imaging. Arch Dis Child Fetal Neonatal Ed 88: F525–F530
Pryds O, Edwards AD 1996 Cerebral blood flow in the newborn infant. Arch Dis Child Fetal Neonatal Ed 74: F63–F69
Miranda MJ, Olofsson K, Sidaros K 2006 Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling. Pediatr Res 60: 359–363
Smith MA 1990 The measurement and visualisation of vessel blood flow by magnetic resonance imaging. Clin Phys Physiol Meas 11: 101–123
Patel J, Marks K, Roberts I, Azzopardi D, Edwards AD 1998 Measurement of cerebral blood flow in newborn infants using near infrared spectroscopy with indocyanine green. Pediatr Res 43: 34–39
Goff DA, Buckley EM, Durduran T, Wang J, Licht DJ 2010 Noninvasive cerebral perfusion imaging in high-risk neonates. Semin Perinatol 34: 46–56
Greisen G, Johansen K, Ellison PH, Fredriksen PS, Mali J, Friis-Hansen B 1984 Cerebral blood flow in the newborn infant: comparison of Doppler ultrasound and 133Xenon clearance. J Pediatr 104: 411–418
Hansen NB, Stonestreet BS, Rosenkrantz TS, Oh W 1983 Validity of Doppler measurements of anterior cerebral artery blood flow velocity. Correlation with brain blood flow in piglets. Pediatrics 72: 526–531
Wolf M, Greisen G 2009 Advances in near-infrared spectroscopy to study the brain of the preterm and term neonate. Clin Perinatol 36: 807–834
Dubois J, Benders M, Borradori-Tolsa C, Cachia A, Lazeyras F, Ha-Vinh-Leuchter R, Sizonenko SV, Warfield SK, Mangin JF, Huppi PS 2008 Primary cortical folding in the human newborn: an early marker of later functional development. Brain 131: 2028–2041
Cowan F, Rutherford M, Groenendaal F, Eken P, Mercuri E, Bydder GM, Meiners LC, Dubowitz LM, de Vries LS 2003 Origin and timing of brain lesions in term infants with neonatal encephalopathy. Lancet 361: 736–742
van Kooij BJ, Hendrikse J, Benders MJ, de Vries LS, Groenendaal F 2010 Anatomy of the circle of Willis and blood flow in the brain-feeding vasculature in prematurely born infants. Neonatology 97: 235–241
Hendrikse J, de Vries LS, Groenendaal F 2006 Magnetic resonance angiography of cerebral arteries after neonatal venoarterial and venovenous extracorporeal membrane oxygenation. Stroke 37: e15–e17
Kehrer M, Goelz R, Krägeloh-Mann I, Schöning M 2002 Measurement of volume of cerebral blood flow in healthy preterm and term neonates with ultrasound. Lancet 360: 1749–1750
Hendrikse J, Klijn CJ, van Huffelen AC, Kappelle LJ, van der Grond J 2008 Diagnosing cerebral collateral flow patterns: accuracy of non-invasive testing. Cerebrovasc Dis 25: 430–437
de Boorder MJ, Hendrikse J, van der Grond J 2004 Phase-contrast magnetic resonance imaging measurements of cerebral autoregulation with a breath-hold challenge: a feasibility study. Stroke 35: 1350–1354
van Osch MJ, Hendrikse J, Golay X, Bakker CJ, van der Grond J 2006 Non-invasive visualization of collateral blood flow patterns of the circle of Willis by dynamic MR angiography. Med Image Anal 10: 59–70
Slinker BK, Glantz SA 1990 Missing data in two-way analysis of variance. Am J Physiol 258: R291–R298
Teitel DF, Klautz RJ, Steendijk P, van der Velde ET, van Bel F, Baan J 1991 The end-systolic pressure-volume relationship in the newborn lamb: effects of loading and inotropic interventions. Pediatr Res 29: 473–482
Baenziger O, Jaggi JL, Mueller AC, Morales CG, Lipp HP, Lipp AE, Duc G, Bucher HU 1994 Cerebral blood flow in preterm infants affected by sex, mechanical ventilation, and intrauterine growth. Pediatr Neurol 11: 319–324
Wintermark M, Sesay M, Barbier E, Birbely K, Dillon WP, Eastwood JD, Glenn TC, Grandin CB, Pedraza S, Soustiel JF, Nairai T, Zaharchuk G, Caille JM, Dousset V, Yonas H 2005 Comparative overview of brain perfusion imaging techniques. J Neuroradiol 32: 294–314
Wolf RL, Detre JA 2007 Clinical neuroimaging using arterial spin-labeled perfusion magnetic resonance imaging. Neurotherapeutics 4: 346–359
Wang J, Licht DJ 2006 Pediatric perfusion MR imaging using arterial spin labelling. Neuroimaging Clin N Am 16: 149–167
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Benders, M., Hendrikse, J., de Vries, L. et al. Phase-Contrast Magnetic Resonance Angiography Measurements of Global Cerebral Blood Flow in the Neonate. Pediatr Res 69, 544–547 (2011). https://doi.org/10.1203/PDR.0b013e3182176aab
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/PDR.0b013e3182176aab
This article is cited by
-
Magnetic resonance imaging based noninvasive measurements of brain hemodynamics in neonates: a review
Pediatric Research (2016)
-
Fetal blood flow velocimetry by phase-contrast MRI using a new triggering method and comparison with Doppler ultrasound in a sheep model: a pilot study
Magnetic Resonance Materials in Physics, Biology and Medicine (2013)
-
Changes in carotid blood flow after unilateral perinatal arterial ischemic stroke
Pediatric Research (2012)
