Development of Cerebral Blood Flow Volume in Preterm Neonates during the First Two Weeks of Life

Kehrer, Martin; Blumenstock, Gunnar; Ehehalt, Stefan; Goelz, Rangmar; Poets, Christian F.; Schöning, M.

doi:10.1203/01.pdr.0000182579.52820.c3

Cited by 83 publications

(43 citation statements)

References 19 publications

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“…Given the overall clinical stability of this cohort of infants, it is likely that this transitional change in basal ganglia blood flow is a normal physiological process as the systemic blood flow increases. This is consistent with other studies investigating surrogate markers of cerebral blood flow during the transitional period (4,17,18). This means that central regions of the brain, which are extremely sensitive to alterations in blood flow, follow a similar progression during the transitional period when compared to global cerebral blood flow.…”

Section: Transitional Basal Ganglia Perfusionsupporting

confidence: 91%

“…Given that the interval between examinations increased at each time point, this suggests that the rate of increase in blood flow per unit time decreased throughout transition. This is also consistent with transitional assessments using other modalities (4,17,18). We noted that gestation did not appear to affect these transitional changes in regional blood flow although our numbers were too small to formally assess this.…”

Section: Transitional Basal Ganglia Perfusionsupporting

confidence: 87%

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Basal ganglia perfusion in the preterm infant during transition

et al. 2016

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Background:The preterm brain is susceptible to changes in blood flow. Using power Doppler images, digital imaging techniques have been developed to measure the total amount of blood flow in a defined area, giving the index: fractional moving blood volume (FMBV). The aim of this study was to investigate temporal changes in basal ganglia perfusion during the transitional period after birth. Methods: Twenty-four preterm infants were examined with serial cranial ultrasounds at four time points during the first 48 h of life. FMBV was calculated using power Doppler images at each time point. results: All infants had analyzable data and FMBV was successfully calculated at all time points. Twenty-three of the 24 infants had an increasing trend in FMBV over time. The median FMBV increased from 17% at 6 h to 25% at 48 h. Oneway repeated measures ANOVA showed a significant increase in values at P < 0.001 at each of the four time points. conclusion: We have demonstrated changes in basal ganglia blood flow as the cerebral circulation adapts to extrauterine life. With further investigation, this technique may be useful in the assessment of preterm circulatory adaptation, either alone or in conjunction with other modes of evaluating cerebral blood flow.

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Section: Transitional Basal Ganglia Perfusionsupporting

confidence: 91%

Section: Transitional Basal Ganglia Perfusionsupporting

confidence: 87%

Basal ganglia perfusion in the preterm infant during transition

et al. 2016

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“…65,66 It is challenging to perform ASL MR imaging in neonates due to the low baseline CBF compared with children and adults, coupled with the low SNR of the method. As an example, velocities are lower in neonates than in children, increasing with postmenstrual age, 67 and the optimum postlabeling delay for contrast-to-noise ratio has been correlated with the mean velocity in the carotid arteries. 68 Moreover, in children and neonates, there is a physiologic improvement in the SNR compared with healthy adults due to a longer tissue T1, longer blood T1, and the higher blood-brain partition coefficient of water.…”

Section: Brain Perfusion Measurements By Using Mr Imagingmentioning

confidence: 99%

Brain Perfusion Imaging in Neonates: An Overview

Proisy

Mitra

Uria-Avellana

et al. 2016

AJNR Am J Neuroradiol

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SUMMARY:The development of cognitive function in children has been related to a regional metabolic increase and an increase in regional brain perfusion. Moreover, brain perfusion plays an important role in the pathogenesis of brain damage in high-risk neonates, both preterm and full-term asphyxiated infants. In this article, we will review and discuss several existing imaging techniques for assessing neonatal brain perfusion. ABBREVIATIONS:ASL ϭ arterial spin-labeling; HIE ϭ hypoxic-ischemic encephalopathy; NIRS ϭ near-infrared spectroscopy

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“…This study is the first to provide longitudinal data of CBF during the first 30 mo after birth. The method is noninvasive and innocuous and therefore suited for serial measurements, which has been shown in adult neurointensive care patients (3,4) and in a longitudinal study in preterm infants (5). The accuracy of the measurement depends on a motionless position of the patient and a strict compliance with a standardized study protocol.…”

Section: Introductionmentioning

confidence: 99%

A Longitudinal Study of Cerebral Blood Flow Over the First 30 Months

Kehrer

Schöning

2009

Pediatr Res

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ABSTRACT:To investigate prospectively the development of cerebral perfusion during infancy, serial quantitative measurements of cerebral blood flow (CBF) volume were performed in two healthy children from birth up to the age of 30 mo. A total of 28 CBF volume measurements were done in either of the children. Absolute flows were measured in the internal carotid and vertebral arteries on both sides. Blood flow was calculated as the product of angle-corrected time-averaged flow velocity and the cross-sectional area of the vessel. Starting from 67 and 80 mL/min, respectively, at birth an almost 10-fold increase of CBF volume was observed in both children during the examination period. Half of this rise occurred during the first 6 mo, probably reflecting the steep metabolic incline during this period of synaptogenesis. The continuous increase in CBF volume after the sixth month of life mainly corresponds to brain growth. Estimated CBF (based on estimated brain weights) increased from 21 and 23 mL 100 g Ϫ1 min Ϫ1 , respectively, after birth to 46 and 53 mL 100 g Ϫ1 min Ϫ1 , respectively, during the first 6 mo of life in both children, remaining stable thereafter. This study is the first to provide longitudinal data of CBF during the first 30 mo after birth. The method is noninvasive and innocuous and therefore suited for serial measurements, which has been shown in adult neurointensive care patients (3,4) and in a longitudinal study in preterm infants (5). The accuracy of the measurement depends on a motionless position of the patient and a strict compliance with a standardized study protocol. In a first interobserver reproducibility performed in children and adults, a 10.0% coefficient of variation has been found (6). The result was comparable with that of a reproducibility study in adult men where two subsequent H 2 15 O-PET scans had been done (7). A recent interobserver reproducibility study performed in neonates resulted in a coefficient of variation of only 6.3% (8).Reference data for CBF volume are available for preterm and term neonates (gestational age, 32-42 wk) (9) and for children from 3 y up to the age of 18 y (10). Although the CBF volume in term neonates is about 70 mL/min (9), it is 10 times higher in 3-y-old children (about 700 mL/min) (10). The dynamics of CBF volume increase, however, from birth up to the age of 3 y is still unclear. The aim of the presented longitudinal study was to describe the development of cerebral perfusion during the first 30 mo of life by serial measurements of CBF volume in two healthy children. METHODSProbands. Two healthy, term born children [1 female ("F"), 1 male ("M")] were involved in a prospective study. Birth weights were 3210 g (M) and 2810 g (F), body lengths at birth were 53 cm (M) and 50 cm (F), and head circumferences at birth were 34.0 cm (M) and 33.0 cm (F). Cerebral B-mode ultrasound examinations performed until the closure of the anterior fontanel were always normal in both children. Neither of them ever presented cardiologic or neurologic abnormalities or ...

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Development of Cerebral Blood Flow Volume in Preterm Neonates during the First Two Weeks of Life

Cited by 83 publications

References 19 publications

Basal ganglia perfusion in the preterm infant during transition

Basal ganglia perfusion in the preterm infant during transition

Brain Perfusion Imaging in Neonates: An Overview

A Longitudinal Study of Cerebral Blood Flow Over the First 30 Months

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