Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
1] Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA [2] Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Cereb Blood Flow Metab. 2014 Mar;34(3):380-8. doi: 10.1038/jcbfm.2013.214. Epub 2013 Dec 11.
Neonatal congenital heart disease (CHD) is associated with altered cerebral hemodynamics and increased risk of brain injury. Two novel noninvasive techniques, magnetic resonance imaging (MRI) and diffuse optical and correlation spectroscopies (diffuse optical spectroscopy (DOS), diffuse correlation spectroscopy (DCS)), were employed to quantify cerebral blood flow (CBF) and oxygen metabolism (CMRO(2)) of 32 anesthetized CHD neonates at rest and during hypercapnia. Cerebral venous oxygen saturation (S(v)O(2)) and CBF were measured simultaneously with MRI in the superior sagittal sinus, yielding global oxygen extraction fraction (OEF) and global CMRO(2) in physiologic units. In addition, microvascular tissue oxygenation (StO(2)) and indices of microvascular CBF (BFI) and CMRO(2) (CMRO(2)(i)) in the frontal cortex were determined by DOS/DCS. Median resting-state MRI-measured OEF, CBF, and CMRO(2) were 0.38, 9.7 mL/minute per 100 g and 0.52 mL O(2)/minute per 100 g, respectively. These CBF and CMRO(2) values are lower than literature reports for healthy term neonates (which are sparse and quantified using different methods) and resemble values reported for premature infants. Comparison of MRI measurements of global S(v)O(2), CBF, and CMRO(2) with corresponding local DOS/DCS measurements demonstrated strong linear correlations (R(2)=0.69, 0.67, 0.67; P<0.001), permitting calibration of DOS/DCS indices. The results suggest that MRI and optics offer new tools to evaluate cerebral hemodynamics and metabolism in CHD neonates.
新生儿先天性心脏病（CHD）与脑血流动力学改变和脑损伤风险增加有关。本研究采用两种新的非侵入性技术，即磁共振成像（MRI）和漫射光学及相关光谱学（漫射光学光谱学（DOS）、漫射相关光谱学（DCS）），来定量测量 32 例麻醉状态下 CHD 新生儿在静息和高碳酸血症期间的脑血流（CBF）和氧代谢（CMRO2）。通过 MRI 在矢状窦上同时测量脑静脉血氧饱和度（SvO2）和 CBF，得出生理单位的全局氧摄取分数（OEF）和全局 CMRO2。此外，通过 DOS/DCS 测定前额皮质的微血管组织氧饱和度（StO2）和微血管 CBF（BFI）和 CMRO2（CMRO2（i））的指数。中位静息状态 MRI 测量的 OEF、CBF 和 CMRO2 分别为 0.38、9.7ml/min/100g 和 0.52ml O2/min/100g。这些 CBF 和 CMRO2 值低于文献报道的健康足月新生儿（这些报道很少，且使用不同的方法进行量化），与早产儿报道的值相似。MRI 测量的全局 SvO2、CBF 和 CMRO2 与相应的局部 DOS/DCS 测量值之间的比较显示出很强的线性相关性（R2=0.69、0.67、0.67；P<0.001），允许对 DOS/DCS 指数进行校准。结果表明，MRI 和光学技术为评估 CHD 新生儿的脑血流动力学和代谢提供了新的工具。
