Fraction of Inspired Oxygen in Relation to Cerebrospinal Fluid  Hyperintensity on FLAIR MR Imaging of the Brain in Children and Young Adults  Undergoing Anesthesia

Frigon, Chantal; Jardine, David S.; Weinberger, Ed; Heckbert, Susan R.; Shaw, Dennis

doi:10.2214/ajr.179.3.1790791

Cited by 39 publications

(40 citation statements)

References 8 publications

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“…Grupların HSA saptanan bölge sayıları karşılaştırıldığında, %100 oksijen grubunda HSA saptanan ortalama beyin bölgesi sayısı ile (4,9), %50 oksijen grubunda HSA saptanan beyin bölgesi sayısı (3,8) arasında anlamlı bir farklılık saptanmadı (p>0,05).…”

Section: Bulgularunclassified

“…ise HSA yönünden propofol, halotan, izofluran, azot protoksit ve midazolam arasında anlamlı fark izlememişlerdir. 8 Ayrıca izofluranla anestezi uygulanan hastalarda da, herhangi bir anestezi uygulanmayan gönüllülerde de benzer şekilde HSA izlenmiş olması, bu bulgunun ortaya çıkmasında anesteziklerin sorumlu olmadığı-nı düşündürmektedir. 7,10 Hiperintens sinyal anomalisi ile anestezikler arasında kesin bir bağlantı kurulamamış olması nedeniyle, daha sonraki çalışmalar oksijen üzeri-ne yoğunlaşmaya başlamış ve FLAIR görüntülerde hiperintensite gözlenmesinin, oksijenin zayıf paramanyetik etkisine bağlı olabileceği ileri sürülmüş-tür.…”

Section: J Clin Exp Invest Wwwjceionlineorg Vol 3 No 4 December 2012unclassified

“…7,10 Hiperintens sinyal anomalisi ile anestezikler arasında kesin bir bağlantı kurulamamış olması nedeniyle, daha sonraki çalışmalar oksijen üzeri-ne yoğunlaşmaya başlamış ve FLAIR görüntülerde hiperintensite gözlenmesinin, oksijenin zayıf paramanyetik etkisine bağlı olabileceği ileri sürülmüş-tür. 8,10 Bu görüşe göre, oksijenin BOS'taki parsiyel basıncının artması, FLAIR sekanslarında hiperintensiteye neden olabilen bir etkendir. Daha sonra yapılan bazı klinik çalışmalar da, HSA'nın oksijenle bağlantılı olduğu varsayımını destekler niteliktedir.…”

Section: J Clin Exp Invest Wwwjceionlineorg Vol 3 No 4 December 2012unclassified

“…Daha sonra yapılan bazı klinik çalışmalar da, HSA'nın oksijenle bağlantılı olduğu varsayımını destekler niteliktedir. [8][9][10][11][12] Örneğin bir çalışmada, azot protoksit kullanılan ve inspire edilen oksijen fraksiyonun düşük olduğu gruptaki hiçbir hastada HSA görülmemiştir. 8 Dolayısıyla artık yaygın kabul gören görüş, MR'daki FLAIR görüntülerde HSA'ya yolaçan nedenin oksijen olduğu şeklindedir.…”

Section: J Clin Exp Invest Wwwjceionlineorg Vol 3 No 4 December 2012unclassified

“…Daha önce gerçekleştirilen çalış-malar da, hem yüz maskesiyle hem de endotrakeal tüp ya da larengeal maske gibi havayolu gereçleriy-le verilen oksijenin HSA'ya neden olduğunu göster-mişlerdir. [8][9][10][11][12] Ancak bu konuda yapılan diğer yayınlar incelendiğinde, çalışma dizaynları arasında farklılıklar olduğu göze çarpmaktadır.…”

Section: J Clin Exp Invest Wwwjceionlineorg Vol 3 No 4 December 2012unclassified

See 4 more Smart Citations

Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Acar¹,

Yiğit²,

Korkulu³

et al. 2012

J Clin Exp Invest

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Objectives: In this study our aim was to compare possible effects of two different oxygen concentrations (100% vs. 50%) on hyperintense signal abnormality (HSA) in pediatric patients undergoing cranial magnetic resonance imaging (MRI) under sevoflurane anesthesia. Materials and methods:Thirty pediatric patients undergoing cranial MRI were studied. Sevoflurane was used for induction and maintenance of anesthesia with an MRcompatible anesthesia machine. Patients, whose airway patency was maintained with laryngeal mask, were divided randomly in two groups. 100% oxygen and 50% oxygen/50% nitrous oxide was used for maintenance of anesthesia in Group I and II, respectively. FLAIR sequence images were analyzed by a radiologist who was unaware of the groups and were evaluated for HSA in 11 different brain regions in cerebrospinal fluid neighborhood. A three-point scale was used for evaluation. Results:HSA was seen in all study patients at least in one brain region. However, no significant difference was obtained between two groups in almost all brain regions (p>0.05).Conclusions: Use of oxygen in pediatric patients undergoing cranial MRI under sevoflurane anesthesia caused a low grade HSA. However, concentration of oxygen had no significant effect on the severity of HSA. J Clin Exp Invest 2012; 3(4): 477-482

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Section: Bulgularunclassified

Section: J Clin Exp Invest Wwwjceionlineorg Vol 3 No 4 December 2012unclassified

See 3 more Smart Citations

Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Acar¹,

Yiğit²,

Korkulu³

et al. 2012

J Clin Exp Invest

View full text Add to dashboard Cite

show abstract

Measurement of cerebrospinal fluid oxygen partial pressure in humans using MRI

Zaharchuk

Martin

Rosenthal

et al. 2005

Magnetic Resonance in Med

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Fluid-attenuated inversion recovery (FLAIR) images obtained during the administration of supplemental oxygen demonstrate a hyperintense signal within the cerebrospinal fluid (CSF) that is likely caused by T 1 changes induced by paramagnetic molecular oxygen. Previous studies demonstrated a linear relationship between the longitudinal relaxation rate (R 1 ‫؍‬ 1/T 1 ) and oxygen content, which permits quantification of the CSF oxygen partial pressure (P csf O 2 ). In the current study, CSF T 1 was measured at 1.5 T in the lateral ventricles, third ventricle, cortical sulci, and basilar cisterns of eight normal subjects breathing room air or 100% oxygen. Phantom studies performed with artificial CSF enabled absolute P csf O 2 quantitation. Regional P csf O 2 differences on room air were observed, from 65 ؎ 27 mmHg in the basilar cisterns to 130 ؎ 49 mmHg in the third ventricle. During 100% oxygen, P csf O 2 increases of 155 ؎ 45 and 124 ؎ 34 mmHg were measured in the basilar cisterns and cortical sulci, respectively, with no change observed in the lateral or third ventricles. P csf O 2 measurements in humans breathing room air or 100% oxygen using a Cerebrospinal fluid (CSF) oxygen partial pressure (P csf O 2 ) has been proposed as a surrogate marker for brain or spinal cord tissue oxygenation, given the passive nature of oxygen diffusion (1-5). Historically, investigators have measured P csf O 2 by analyzing fluid obtained by direct cisternal or lumbar puncture, or using implanted oxygen microelectrodes. These methods are inconvenient and invasive, and are limited in terms of spatial information and repeatability. Additionally, methods that remove fluid are prone to errors introduced by exposure of CSF to room air before the analysis is performed (6). It is possible that differences exist between CSF compartments caused by local brain tissue oxygen levels, oxygen permeability-surface area product, oxygen diffusion, CSF flow, and cerebral blood flow (CBF). A noninvasive imaging method to determine P csf O 2 would permit repeated measurements with spatial sensitivity during physiological manipulations. Through these means, a more complete understanding of CSF oxygen dynamics could be obtained that might yield insights into local brain or spinal cord oxygen levels in normal and abnormal physiologic states.Normal CSF at body temperature has MR properties that are essentially identical to those of partially oxygenated water, with a well-regulated pH (7.3) and a trace amount of protein (0.15-0.45 g/L) (7,8). Using invasive means, P csf O 2 has been measured to be between 25-53 mmHg in humans, roughly 25% its room air level (160 mmHg) (2-5,9). Previous studies in humans have suggested that P csf O 2 changes occur in the setting of abnormal brain oxygen metabolism (1,4,5).It is likely that the increased CSF signal within the subarachnoid spaces of the cerebral sulci and basilar cisterns on fluid-attenuated inversion recovery (FLAIR) images in humans breathing supplemental oxygen reflects higher than normal P csf O 2 , whi...

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Neuroimaging of traumatic brain injury

Gean

2009

Mount Sinai J Medicine

145

115

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In this article, the neuroradiological evaluation of traumatic brain injury is reviewed. Different imaging strategies in the assessment of traumatic brain injury are initially discussed, and this is followed by a review of the imaging characteristics of both primary and secondary brain injuries. Computed tomography remains the modality of choice for the initial assessment of acute head injury because it is fast, widely available, and highly accurate in the detection of skull fractures and acute intracranial hemorrhage. Magnetic resonance imaging is recommended for patients with acute traumatic brain injury when the neurological findings are unexplained by computed tomography. Magnetic resonance imaging is also the modality of choice for the evaluation of subacute or chronic traumatic brain injury. Mild traumatic brain injury continues to be difficult to diagnose with current imaging technology. Advanced magnetic resonance techniques, such as diffusion-weighted imaging, magnetic resonance spectroscopy, and magnetization transfer imaging, can improve the identification of traumatic brain injury, especially in the case of mild traumatic brain injury. Further research is needed for other advanced imaging methods such as magnetic source imaging, single photon emission tomography, and positron emission tomography.

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Fraction of Inspired Oxygen in Relation to Cerebrospinal Fluid Hyperintensity on FLAIR MR Imaging of the Brain in Children and Young Adults Undergoing Anesthesia

Cited by 39 publications

References 8 publications

Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Does oxygen use during general anesthesia cause an artifact in magnetic resonance images?

Measurement of cerebrospinal fluid oxygen partial pressure in humans using MRI

Neuroimaging of traumatic brain injury

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