Cerebral Blood Flow Measured by Phase-Contrast Magnetic Resonance Angiography in Preterm and Term Neonates

Wagenaar, Nienke; Rijsman, Lucas H; Nieuwets, Astrid; Groenendaal, Floris

doi:10.1159/000494368

Cited by 9 publications

(6 citation statements)

References 28 publications

(42 reference statements)

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“…TRANCE-MRI has been applied in cranial neurological diseases and arterial diseases and recently used for venous pathology in the lower extremities in our institution for evaluating complicated venous diseases, including static foot ulcers. 5,35,36 The value of the TRANCE-MRI was adequately demonstrated in the present study; the technique revealed that two additional patients with static ulcer had DVT, which venous duplex study did not detect. If this new imaging tool is employed in the leg venous system, oral anticoagulation will be delivered more precisely according to the comprehensive venous system information obtained.…”

Section: Discussionsupporting

confidence: 61%

Evaluation of static ulcer on lower extremities using wireless wearable near-infrared spectroscopy device: Effect of deep venous thrombosis on TRiggered Angiography Non-Contrast-Enhanced sequence magnetic resonance imaging

et al. 2020

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Background Venous leg ulcers, or static leg ulcers, are chronic wounds associated with ambulatory venous hypertension of the lower extremities as a consequence of venous valve reflux, reduce venous capacitance, poor calf venous pump, heart failure, or in conjunction with venous obstruction. A static ulcer with venous thrombosis in a pelvic or thigh vein responds favorably to anticoagulation agents. However, anticoagulation is less effective and even harmful when ambulatory venous hypertension has another cause such as venous reflux, poorly heart function, and poor calf venous pump. Method TRiggered Angiography Non-Contrast-Enhanced (TRANCE) magnetic resonance imaging (MRI) exploits differences in vascular signal intensity during the cardiac cycle for subsequent image subtraction, providing detailed radiation-free venograms without the use of contrast agents. The method is a new tool for evaluating the presence of thrombosis in the venous systems. TRANCE-MRI was employed to document the existence of venous thrombosis within the eight patients in this study. Subsequently, we used a wireless wearable near-infrared spectroscopy device to compare deep vein thrombosis-associated and non-deep vein thrombosis-associated static ulcers. The sampling depths were 5 and 10 mm, representing the dermis and subcutaneous tissue, respectively. Result There are four patients with venous leg ulcers proven with venous thrombosis by TRANCE-MRI and are classified as deep vein thrombosis group. Compared with the non-deep vein thrombosis group, the deep vein thrombosis group had less deoxyhemoglobin, less total hemoglobin, and a significantly lower H2O signal in the 5-mm sampling depth (dermis level). And eight health participants were included as control group. Wounded patients (including deep vein thrombosis and non-deep vein thrombosis patients) have higher H2O concentration on the 5-mm depth sampling than control group. In the 10-mm sampling depth (subcutaneous level), the deoxyhemoglobin and tissue oxygen saturation of the deep vein thrombosis group were lower than those of the non-deep vein thrombosis group, and the H2O concentration was higher than non-deep vein thrombosis group. Patients with static foot ulcers and deep vein thrombosis had similar oxyhemoglobin, deoxyhemoglobin, total hemoglobin, and tissue oxygen saturation than did those without deep vein thrombosis in 5-mm depth sampling (dermis level). Notably, the H2O signal of patients with non-deep vein thrombosis-associated static ulcers was higher for the 5-mm sampling depth. Conclusion In patients with static ulcers and deep vein thrombosis, the H2O level may be higher in the 10-mm sampling depth, indicating that those patients had more subcutaneous water. In patients with non-deep vein thrombosis static foot ulcer, the near-infrared spectroscopy (NIRS) indicated worse fluid retention in the dermis level. The H2O value in the NIRS may be different owing to underline the cause of the venous leg ulcers.

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Section: Discussionsupporting

confidence: 61%

Evaluation of static ulcer on lower extremities using wireless wearable near-infrared spectroscopy device: Effect of deep venous thrombosis on TRiggered Angiography Non-Contrast-Enhanced sequence magnetic resonance imaging

et al. 2020

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“…Greisen et al reported that global CBF in premature non-distressed infants measured with 133 Xenon was 20 ml/100 g/ml [22]. Kehrer et al calculated CBF from cross sectional area of extracranial internal carotid artery (ICA) and angle-corrected time-averaged flow velocity of intracranial ICA and reported to be around 23 ml/min in preterm infants between 28 and 31 weeks' gestational age at day 1 [23], while CBF measured by phase-contrast magnetic resonance angiography and corrected for body weight ranged between 9.8 and 94.0 mL/min/kg (median 28.5 mL/min/ kg) [24]. In the current work, the reported median SVCF in There is no known report for actual CBF in premature patients with IVH, and it is expected to be dynamic according to hypoperfusion or reperfusion stage.…”

Section: Discussionmentioning

confidence: 99%

Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring: a prospective cohort study

et al. 2022

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Unstable hemodynamics and prematurity are the main players in intraventricular hemorrhage (IVH) development. Our objective was to study 8 the use of superior vena cava flow (SVCF), left ventricular output (LVO), and right ventricular output (RVO), and anterior cerebral artery (ACA) Doppler measures in prediction of IVH in the first week of life in preterm infant ≤ 32 weeks and birth weight ≤ 1500 g. This prospective cohort study was conducted in 55NICU of Alexandria University maternity hospital. Of 147 enrolled patients, 132 infants born ≤ 32 weeks GA and birth weight ≤ 1500 g were eligible for- the study. One hundred twenty-seven infants completed the study. Infants were scanned for ACA-RI using transfontanellar ultrasound, and SVCF, LVO, and RVO using functional echocardiography in the first 24 h after birth. Patients had another two scans on DOL3 and 7 to detect IVH development. Low SVCF and high ACA-RI significantly increased the risk of IVH using logistic regression models with OR, 3.16; 95%CI, 1.19–8.39; P = 0.02 and OR, 1.64; 95%Cl, 1.10–2.44; P = 0.02, respectively. Low SVCF and high ACA-RI significantly increased risk of catastrophic IVH P = 0.025 and 0.023, respectively. Combined use of low SVCF < 55 ml/kg/min and ACA-RI > 0.75 is predictor of IVH with sensitivity 40.8% and 82.1% specificity.Conclusions: There are strong relations between both low SVCF and high ACA-RI, and IVH development in premature neonates ≤ 32 weeks and birth weight ≤ 1500 g, with more significance towards catastrophic IVH. Admission RSS and LVO are the strongest factors affecting SVCF. Maternal anemia, patent ductus arteriosus size (mm/kg), and capillary refill time were significantly associated with high ACA-RI. These findings help in more understanding of pathophysiological factors affecting central perfusion that might affect the longer term neurodeveopmental outcome.Trial registration: This work was registered in clinical trial.gv no NCT05050032. What is Known:•Whether SVCF and RI-ACA can predict IVH in preterm neonates is still debatable. What is New:•Low SVC flow and high ACA-RI significantly increased risk of IVH, confirming the role of hypoperfusion-reperfusion cycle in IVH development. The most striking result that combined metrics using the cut-off value of < 41 ml/kg/min for SVCF and > 0.85 for ACA-RI “in the first day of life” can correctly reject the presence of IVH in 98% of patients “during the first week of life.”

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“…Similar study was done in larger cohort of 344 infants, included 172 preterm infants and 172 term infants. This study concluded that mean CBF assessed by PCMRA is dependent on body weight and estimated brain weight also this mean CBF is more in term infants when compared to preterm infants at term equivalent age [19].…”

Section: Phase-contrast (Pc) Mri Is Another Technique Of Assessing Th...mentioning

confidence: 65%

Neuroimaging in Neonates: Newer Insights

Veluchamy¹

2024

Frontiers in Neuroimaging

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Neuroimaging plays a key role in management of critically ill neonates with neurological problems. Magnetic Resonance Imaging (MRI) is the most commonly used neuroimaging modality in evaluation of neonatal encephalopathy, because MRI provides better image quality and accurate delineation of the lesion. Newer modalities of MRI like Diffusion Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI) are useful in identifying the brain lesion and also in predicting the neurodevelopmental outcome. Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) are used to assess the cerebral arteries and veins with or without the use of contrast material. Arterial Spin Labelling (ASL) MRI and Phase Contrast (PC) MRI are newer modalities of MRI used to assess the cerebral perfusion without the use of contrast material. Magnetic Resonance Spectroscopy (MRS) is a functional MRI modality used to assess the level of brain metabolites which help us in diagnosing neuro metabolic disorders, peroxisomal disorders and mitochondrial disorders. Several predictive scores are available based on the size and location of lesions in MRI, and these scores are used to predict the neurodevelopmental outcome in term neonates with encephalopathy. MRI at term equivalent age in preterm neonates used to predict neurodevelopmental outcome in later life.

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Cerebral Blood Flow Measured by Phase-Contrast Magnetic Resonance Angiography in Preterm and Term Neonates

Cited by 9 publications

References 28 publications

Evaluation of static ulcer on lower extremities using wireless wearable near-infrared spectroscopy device: Effect of deep venous thrombosis on TRiggered Angiography Non-Contrast-Enhanced sequence magnetic resonance imaging

Evaluation of static ulcer on lower extremities using wireless wearable near-infrared spectroscopy device: Effect of deep venous thrombosis on TRiggered Angiography Non-Contrast-Enhanced sequence magnetic resonance imaging

Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring: a prospective cohort study

Neuroimaging in Neonates: Newer Insights

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