Cerebral oxygen metabolism in neonates with congenital heart disease quantified by MRI and optics
Cerebral oxygen metabolism in neonates with congenital heart disease quantified by MRI and optics
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DOI：
10.1038/jcbfm.2013.214
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发表时间：
2014-03-01
影响因子：
6.3
通讯作者：
Wehrli, Felix W.
中科院分区：
文献类型：
--
作者：
Jain, Varsha;Buckley, Erin M.;Wehrli, Felix W.
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。采用磁共振成像（MRI）和漫射光学及相关光谱（漫射光学光谱（DOS）、漫射相关光谱（DCS））两种新型无创技术，对32例麻醉的冠心病新生儿静息和高碳酸血症时的脑血流量（CBF）和氧代谢（cmo2）进行了定量分析。MRI同时测量上矢状窦脑静脉血氧饱和度（SO2）和脑血流（CBF），得到生理单位的总吸氧分数（OEF）和总cmo 2。采用DOS/DCS检测大鼠额叶皮层微血管组织氧合（StO(2)）和微血管CBF （BFI）、CMR021 （CMR021）指标。静息状态mri测量的OEF、CBF和cmor2的中位数分别为0.38、9.7 min / 100g和0.52 mL /min / 100g。这些CBF和cmor2值低于文献报道的健康足月新生儿（它们是稀疏的，使用不同的方法进行量化），与早产儿的报道值相似。MRI整体5 +/- 02、CBF和cmor2测量值与相应的局部DOS/DCS测量值的比较显示出很强的线性相关性（R-2=0.69, 0.67, 0.67; P < 0.001），允许校准DOS/DCS指数。结果表明，MRI和光学为评估冠心病新生儿的脑血流动力学和代谢提供了新的工具。
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 (CMRO2) of 32 anesthetized CHD neonates at rest and during hypercapnia. Cerebral venous oxygen saturation (SO2) and CBF were measured simultaneously with MRI in the superior sagittal sinus, yielding global oxygen extraction fraction (OEF) and global CMRO2 in physiologic units. In addition, microvascular tissue oxygenation (StO(2)) and indices of microvascular CBF (BFI) and CMRO2 (CMR021) in the frontal cortex were determined by DOS/DCS. Median resting-state MRI-measured OEF, CBF, and CMRO2 were 0.38, 9.7 mUminute per 100 g and 0.52 mL 02/minute per 100 g, respectively. These CBF and CMRO2 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 5 +/- 02, CBF, and CMRO2 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.