Cerebral blood flow in children with syndromic craniosynostosis: cohort arterial spin labeling studies

Doerga, Priya N.; Lequin, Maarten H.; Dremmen, Marjolein H G; Ottelander, Bianca K. den; Mauff, Katya; Wagner, Matthias; Hernández-Tamames, Juan Antonio; Versnel, Sarah L.; Joosten, Koen; Veelen, Marie-Lise C. van; Tasker, Robert C.; Mathijssen, Irene M J

doi:10.3171/2019.10.peds19150

Cited by 11 publications

(18 citation statements)

References 27 publications

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“…4e). 57,58 Venous Disease Cerebral venous infarction is a rare form of stroke that results from thrombosis in the superficial and/or deep venous systems. Risk factors include dehydration, coagulopathy, hormonal abnormalities, trauma, malignancy, and infectious/ inflammatory conditions.…”

Section: Large Artery Diseasementioning

confidence: 99%

Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Bambach

Smith

Morris

et al. 2020

Magnetic Resonance Imaging

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Arterial spin labeling (ASL) is a powerful noncontrast magnetic resonance imaging (MRI) technique that enables quantitative evaluation of brain perfusion. To optimize the clinical and research utilization of ASL, radiologists and physicists must understand the technical considerations and age-related variations in normal and disease states. We discuss advanced applications of ASL across the lifespan, with example cases from children and adults covering a wide variety of pathologies. Through literature review and illustrated clinical cases, we highlight the subtleties as well as pitfalls of ASL interpretation. First, we review basic physical principles, techniques, and artifacts. This is followed by a discussion of normal perfusion variants based on age and physiology. The three major categories of perfusion abnormalities-hypoperfusion, hyperperfusion, and mixed patterns-are covered with an emphasis on clinical interpretation and relationship to the disease process. Major etiologies of hypoperfusion include large artery, small artery, and venous disease; other vascular conditions; global hypoxic-ischemic injury; and neurodegeneration. Hyperperfusion is characteristic of vascular malformations and tumors. Mixed perfusion patterns can be seen with epilepsy, migraine, trauma, infection/inflammation, and toxicmetabolic encephalopathy. Level of Evidence: 4 Technical Efficacy Stage: 3

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Section: Large Artery Diseasementioning

confidence: 99%

Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Bambach

Smith

Morris

et al. 2020

Magnetic Resonance Imaging

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“…However, automatic methods for spatial normalization are challenging in young children with craniosynostosis as there are issues with low GM/WM contrast and skull deformity, asexplained above ( de Jong et al, 2010 ; Keil et al, 2019 ). In previous ASL studies in craniosynostosis patients, regions of interest (ROI) were therefore placed manually, which made spatial normalization escapable ( Doerga et al, 2019 ). However, this practice is time consuming, and it increases the likelihood of error in delineation and decreases the repeatability across subjects.…”

Section: Introductionmentioning

confidence: 99%

Using Perfusion Contrast for Spatial Normalization of ASL MRI Images in a Pediatric Craniosynostosis Population

et al. 2021

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Spatial normalization is an important step for group image processing and evaluation of mean brain perfusion in anatomical regions using arterial spin labeling (ASL) MRI and is typically performed via high-resolution structural brain scans. However, structural segmentation and/or spatial normalization to standard space is complicated when gray-white matter contrast in structural images is low due to ongoing myelination in newborns and infants. This problem is of particularly clinical relevance for imaging infants with inborn or acquired disorders that impair normal brain development. We investigated whether the ASL MRI perfusion contrast is a viable alternative for spatial normalization, using a pseudo-continuous ASL acquired using a 1.5 T MRI unit (GE Healthcare). Four approaches have been compared: (1) using the structural image contrast, or perfusion contrast with (2) rigid, (3) affine, and (4) nonlinear transformations – in 16 healthy controls [median age 0.83 years, inter-quartile range (IQR) ± 0.56] and 36 trigonocephaly patients (median age 0.50 years, IQR ± 0.30) – a non-syndromic type of craniosynostosis. Performance was compared quantitatively using the real-valued Tanimoto coefficient (TC), visually by three blinded readers, and eventually by the impact on regional cerebral blood flow (CBF) values. For both patients and controls, nonlinear registration using perfusion contrast showed the highest TC, at 17.51 (CI 6.66–49.38) times more likely to have a higher rating and 17.45–18.88 ml/100 g/min higher CBF compared with the standard normalization. Using perfusion-based contrast improved spatial normalization compared with the use of structural images, significantly affected the regional CBF, and may open up new possibilities for future large pediatric ASL brain studies.

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“…13 Craniosynostosis patients present a further challenge given the skull deformations of these patients. 8,14,15…”

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confidence: 99%

Cerebral Blood Flow of the Frontal Lobe in Untreated Children with Trigonocephaly versus Healthy Controls: An Arterial Spin Labeling Study

Planque

Petr

Gaillard

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Craniofacial surgery is the standard treatment for children with moderate to severe trigonocephaly. The added value of surgery to release restriction of the frontal lobes is unproven, however. In this study, the authors aim to address the hypothesis that the frontal lobe perfusion is not restricted in trigonocephaly patients by investigating cerebral blood flow. Methods: Between 2018 and 2020, trigonocephaly patients for whom a surgical correction was considered underwent magnetic resonance imaging brain studies with arterial spin labeling to measure cerebral perfusion. The mean value of cerebral blood flow in the frontal lobe was calculated for each subject and compared to that of healthy controls. Results: Magnetic resonance imaging scans of 36 trigonocephaly patients (median age, 0.5 years; interquartile range, 0.3; 11 female patients) were included and compared to those of 16 controls (median age, 0.83 years; interquartile range, 0.56; 10 female patients). The mean cerebral blood flow values in the frontal lobe of the trigonocephaly patients (73.0 ml/100 g/min; SE, 2.97 ml/100 g/min) were not significantly different in comparison to control values (70.5 ml/100 g/min; SE, 4.45 ml/100 g/min; p = 0.65). The superior, middle, and inferior gyri of the frontal lobe showed no significant differences either. Conclusions: The authors’ findings suggest that the frontal lobes of trigonocephaly patients aged less than 18 months have a normal cerebral blood flow before surgery. In addition to the very low prevalence of papilledema or impaired skull growth previously reported, this finding further supports the authors’ hypothesis that craniofacial surgery for trigonocephaly is rarely indicated for signs of raised intracranial pressure or restricted perfusion for patients younger than 18 months. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

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Cerebral blood flow in children with syndromic craniosynostosis: cohort arterial spin labeling studies

Cited by 11 publications

References 27 publications

Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Using Perfusion Contrast for Spatial Normalization of ASL MRI Images in a Pediatric Craniosynostosis Population

Cerebral Blood Flow of the Frontal Lobe in Untreated Children with Trigonocephaly versus Healthy Controls: An Arterial Spin Labeling Study

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