Neonatal ischemic brain injury: what every radiologist needs to know

Badve, Chaitra; Khanna, Paritosh C.; Ishak, Gisele E.

doi:10.1007/s00247-011-2332-8

Cited by 21 publications

(18 citation statements)

References 48 publications

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“…Figure 1.3 shows sagittal and coronal ultrasonic images of an infant brain acquired 7 weeks after birth. In these images, cystic PVL in the pre-term infant born at 31 weeks is indicated by arrows [50]. However, ultrasonography is relatively insensitive to the diffuse form of PVL in the neonatal period [49,52,53].…”

Section: Periventricular Leukomalaciamentioning

confidence: 99%

“…Periventricular leukomalacia (PVL) refers to ischemic damage to the white matter around the ventricles [49][50][51]. This neuropathologic lesion has emerged as the principal form of brain injury in premature infants.…”

Section: Periventricular Leukomalaciamentioning

confidence: 99%

“…Vascular supply to the cerebral white matter consists of the long and short penetrating arteries (Figure 1 In response to hypoxic ischemic brain injury, the pre-myelinating oligodendrocytes in periventricular white matter undergo necrosis, resulting in PVL [50]. Ultrasonography can be used to identify focal cystic PVL [49,52,53].…”

Section: Periventricular Leukomalaciamentioning

confidence: 99%

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Potential for photoacoustic imaging of the neonatal brain

Tavakolian¹,

Kosik

Chamson-Reig³

et al. 2013

SPIE Proceedings

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Photoacoustic imaging is a hybrid imaging technique that combines many of the merits of both optical and ultrasound imaging. Photoacoustic imaging (PAI) has been hypothesized as a technique for imaging neonatal brain. However, PAI of the brain is more challenging than traditional methods (e.g. near infrared spectroscopy) due to the presence of the skull layer.To evaluate the potential limits the skull places on 3D PAI of the neonatal brain, we constructed a neonatal skull phantom (~1.52-mm thick) with a mixture of epoxy and titanium dioxide powder that provided acoustic insertion loss (1-5MHz) similar to human infant skull bone. The phantom was molded into a realistic infant skull shape by means of a CNCmachined mold that was based upon a 3D CAD model. Then, propagation of photoacoustic (PA) signals through the skull phantom was examined. A photoacoustic point source was raster-scanned within the imaging cavity of a 128-channel PAI system to capture the imaging operator with and without the intervening skull phantom layer. Then, effects of the skull phantom on PA signals and consequently on PA images was evaluated in detail. We captured 3D photoacoustic images of tubes filled with indocyanine green (ICG). The system was capable of reconstructing an image of a tube filled with 50 µM ICG in presence of the skull.Image processing method was developed to correct photoacoustic images from the effects of the skull. The method was tested on an image of an object captured through the skull, which demonstrated that the effects of the skull on PA images are predictable and modifiable.

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Section: Periventricular Leukomalaciamentioning

confidence: 99%

Section: Periventricular Leukomalaciamentioning

confidence: 99%

Section: Periventricular Leukomalaciamentioning

confidence: 99%

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Potential for photoacoustic imaging of the neonatal brain

Tavakolian¹,

Kosik

Chamson-Reig³

et al. 2013

SPIE Proceedings

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“…1 Perinatal brain injury has been associated with impaired cerebral blood flow (CBF) autoregulation to maintain blood flow with respect to arterial blood pressure. Impairment of this homeostatic mechanism has a key role in the pathophysiology of the ischemic and hemorrhagic insults in newborn brains.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Spatio-Temporal Imaging of Early Reflow in a Neonatal Rat Stroke Model

Leger

Bonnin

Lacombe

et al. 2012

J Cereb Blood Flow Metab

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The aim of the study was to better understand blood-flow changes in large arteries and microvessels during the first 15 minutes of reflow in a P7 rat model of arterial occlusion. Blood-flow changes were monitored by using ultrasound imaging with sequential Doppler recordings in internal carotid arteries (ICAs) and basilar trunk. Relative cerebral blood flow (rCBF) changes were obtained by using laser speckle Doppler monitoring. Tissue perfusion was measured with [ 14 C]-iodoantipyrine autoradiography. Cerebral energy metabolism was evaluated by mitochondrial oxygen consumption. Gradual increase in mean blood-flow velocities illustrated a gradual perfusion during early reflow in both ICAs. On ischemia, the middle cerebral artery (MCA) territory presented a residual perfusion, whereas the caudal territory remained normally perfused. On reflow, speckle images showed a caudorostral propagation of reperfusion through anastomotic connections, and a reduced perfusion in the MCA territory. Autoradiography highlighted the caudorostral gradient, and persistent perfusion in ventral and medial regions. These blood-flow changes were accompanied by mitochondrial respiration impairment in the ipsilateral cortex. Collectively, these data indicate the presence of a primary collateral pathway through the circle of Willis, providing an immediate diversion of blood flow toward ischemic regions, and secondary efficient cortical anastomoses in the immature rat brain.

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“…In order to achieve an optimal sensitivity during visualization of ischemic injuries, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences are required, because traditional T1-and T2-weighted sequences may not show ischemic injuries in the first 48-72 hours following stroke initiation (Figure 1). 9,10 In the diffusion image, the infarcted region will appear hyperintense (bright signal). The correlation between a (positive) hyperintense diffusion image and hypointense ADC (dark) confirms the presence of cytotoxic edema and, therefore, the ischemic nature of an acute injury.…”

Section: Clinical Manifestations and Diagnosis Of Perinatal Strokementioning

confidence: 99%

Presumed perinatal ischemic stroke. A review

2015

Arch Argent Pediat

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The risk of stroke is actually highest during the perinatal period. However, some newborn infants may have no signs indicative of the need of brain imaging, or brain images taken may not be sensitive enough to diagnose ischemic injuries; so, the diagnosis of stroke may be delayed several months or years. The neurological picture in patients with perinatal stroke detected through neuroimaging months or years after the neonatal period is called presumed perinatal ischemic stroke. Although a presumed perinatal ischemic stroke is just a confirmation of the existence of an important level of underdiagnosis in relation to perinatal stroke, establishing the extent of this condition has allowed to improve knowledge on perinatal ischemic vascular disease.

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Neonatal ischemic brain injury: what every radiologist needs to know

Cited by 21 publications

References 48 publications

Potential for photoacoustic imaging of the neonatal brain

Potential for photoacoustic imaging of the neonatal brain

Dynamic Spatio-Temporal Imaging of Early Reflow in a Neonatal Rat Stroke Model

Presumed perinatal ischemic stroke. A review

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