Measuring Quantitative Cerebral Blood Flow in Healthy Children: A Systematic Review of Neuroimaging Techniques

Abstract

Cerebral blood flow (CBF) is an important hemodynamic parameter to evaluate brain health. It can be obtained quantitatively using medical imaging modalities such as magnetic resonance imaging and positron emission tomography (PET). Although CBF in adults has been widely studied and linked with cerebrovascular and neurodegenerative diseases, CBF data in healthy children are sparse due to the challenges in pediatric neuroimaging. An understanding of the factors affecting pediatric CBF and its normal range is crucial to determine the optimal CBF measuring techniques in pediatric neuroradiology. This review focuses on pediatric CBF studies using neuroimaging techniques in 32 articles including 2668 normal subjects ranging from birth to 18 years old. A systematic literature search was conducted in PubMed, Embase, and Scopus and reported following the preferred reporting items for systematic reviews and meta‐analyses (PRISMA). We identified factors (such as age, gender, mood, sedation, and fitness) that have significant effects on pediatric CBF quantification. We also investigated factors influencing the CBF measurements in infants. Based on this review, we recommend best practices to improve CBF measurements in pediatric neuroimaging.Level of Evidence1Technical EfficacyStage 2

Macrovascular blood flow and microvascular cerebrovascular reactivity are regionally coupled in adolescence

“…However, we did not observe significant age-related changes in average tissue perfusion or CVR amplitude. Previous investigations of flow 98,103 and CVR amplitude 27,104 during adolescence have reported age-related changes, though most commonly these studies evaluate tissue-level perfusion rather than macrovascular flow. These reports also indicate a nonlinear modeling approach might be more appropriate for capturing age-related perfusion and CVR dynamics, which our sample size is not sufficient to characterize.…”