Zhu Chen Shuang, Chan Natalie, Chacko Anil, Holsti Liisa, Grunau Ruth E, Weber Alexander Mark
School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada.
BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, British Columbia, Canada.
NMR Biomed. 2025 Jun;38(6):e70065. doi: 10.1002/nbm.70065.
Developing a noninvasive method for measuring oxygen consumption at both regional and whole-brain levels in preterm infants is crucial for assessing brain development and neuronal injury in this vulnerable population. This study presents a multi-modal MRI technique and analysis pipeline that produces whole-brain semiregional maps-with the potential to be fully regional-which we employ in a cohort study to investigate how the duration of various respiratory supports in very preterm infants affects CBF and the cerebral metabolic rate of oxygen (CMRO). Infants (n = 19) born < 32 weeks gestational age were recruited in the neonatal intensive care unit. Infants were scanned at term-equivalent age using a 3 T MRI sequence comprising T-weighted, T-weighted, arterial spin labeling (ASL), and SWI. Days on three different categories of respiratory support, based on levels of invasiveness, were recorded. Using multiple linear regression, CBF and CMRO were analyzed against days on: respiratory support, days in room air, and the proportion of days on respiratory support; GA and PMA were used as confounding factors. Average CBF and CMRO of cortical grey matter was 14.3 ± 4.25 mL/100 g/min and 29.49 ± 29.49 μmol/100 g/min, respectively. CMRO and CBF were positively correlated with days on noninvasive respiratory support and negatively correlated with days in room air. Using our novel method, CBF and CMRO values aligned closely with literature values. Our exploratory findings suggest that the type of respiratory support may influence cerebral oxygenation during the neonatal period in infants born very preterm, with greater oxygen delivery and consumption associated with noninvasive respiratory support. Our semiregional brain analysis further highlights that different brain structures are impacted in distinct ways. This study presents a novel multimodal MRI approach to measure cerebral blood flow (CBF) and oxygen metabolism (CMRO) in preterm infants. Exploratory findings suggest noninvasive respiratory support is associated with higher CBF and CMRO, highlighting its potential impact on neonatal brain oxygenation and development.
开发一种用于测量早产儿区域和全脑水平氧消耗的非侵入性方法，对于评估这一脆弱人群的脑发育和神经元损伤至关重要。本研究提出了一种多模态MRI技术和分析流程，可生成全脑半区域图谱（有可能实现完全区域化），我们将其应用于一项队列研究，以探究极早产儿接受各种呼吸支持的持续时间如何影响脑血流量（CBF）和脑氧代谢率（CMRO₂）。在新生儿重症监护病房招募了胎龄<32周的婴儿（n = 19）。在足月等效年龄时，使用包括T加权、T加权、动脉自旋标记（ASL）和磁敏感加权成像（SWI）的3T MRI序列对婴儿进行扫描。记录基于侵入性水平的三种不同类型呼吸支持的天数。使用多元线性回归，分析CBF和CMRO₂与以下天数的关系：呼吸支持天数、在室内空气中的天数以及呼吸支持天数的比例；将胎龄（GA）和产后月龄（PMA）用作混杂因素。皮质灰质的平均CBF和CMRO₂分别为14.3±4.25 mL/100g/min和29.49±29.49 μmol/100g/min。CMRO₂和CBF与无创呼吸支持天数呈正相关，与在室内空气中的天数呈负相关。使用我们的新方法，CBF和CMRO₂值与文献值密切吻合。我们的探索性研究结果表明，呼吸支持类型可能会影响极早产儿新生儿期的脑氧合，无创呼吸支持与更高的氧输送和消耗相关。我们的半区域脑分析进一步强调，不同的脑结构受到的影响方式不同。本研究提出了一种用于测量早产儿脑血流量（CBF）和氧代谢（CMRO₂）的新型多模态MRI方法。探索性研究结果表明，无创呼吸支持与更高的CBF和CMRO₂相关，突出了其对新生儿脑氧合和发育的潜在影响。
