Elsevier

NeuroImage: Clinical

Volume 15, 2017, Pages 401-407
NeuroImage: Clinical

Prematurity and brain perfusion: Arterial spin labeling MRI

https://doi.org/10.1016/j.nicl.2017.05.023Get rights and content
Under a Creative Commons license
open access

Highlights

  • Different ASL cerebral perfusion between preterm and term neonates

  • Global reduction of CBF values in preterm neonates with white matter lesions

  • ASL identifies preterm neonates at higher risk for sub-optimal neuromotor development.

  • Worst 12-months neuromotor outcome in preterm neonates with lower CBF of basal ganglia

Abstract

Purpose

Abnormal brain perfusion is a critical mechanism in neonatal brain injury. The aim of the present study was to compare Cerebral Blood Flow (CBF) evaluated with ASL MRI in three groups of neonates: preterms without brain lesions on MRI (PN), preterms with periventricular white matter lesions (PNp) and term neonates with normal MRI (TN). The correlation between CBF and clinical outcome was explored.

Materials and methods

The institutional review board approved this prospective study and waived informed consent. The perfusion ASL data from 49 consecutive preterm neonates (PN) studied at term-equivalent age and 15 TN were evaluated. Statistically significant differences in gray matter CBF were evaluated by using a linear mixed-model analysis and Mann-Whitney U test. Logistic regression analysis was used to assess the relation between CBF and neuromotor outcome at 12 months.

Results

Comparison of means indicated that the CBF of the whole brain were significantly higher in PN compared to TN (P = 0.011). This difference remained significant when considering the frontal (P = 0.038), parietal (P = 0.002), temporal (P = 0.030), occipital (P = 0.041) and cerebellar (P = 0.010) gray matter. In the PN group, lower CBF in basal ganglia was associated with a worse neuromotor outcome (P = 0.012).

Conclusions

ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.

Abbreviations

ASL
arterial spin labeling
CBF
cerebral blood flow
HIE
hypoxic-ischemic encephalopathy
PN
preterm neonate with normal MRI
PNp
preterm neonate periventricular white matter lesions
PVL
periventricular leukoencephalopathy
TN
term neonate with normal MRI

Keywords

Brain perfusion
Neonate
Prematurity

Cited by (0)