title: Attenuation of cerebral venous contrast in susceptibility-weighted imaging of spontaneously breathing pediatric patients sedated with propofol.
abstract: OBJECTIVE
  SWI is known for its detailed visualization of the cerebral venous system and seems to be a promising tool for early detection of cerebrovascular pathologies in children, who are frequently sedated for MR imaging. Because sedation influences cerebral hemodynamics, we hypothesized that it would affect cerebral venous contrast in SWI.
  
  
  METHODS
  SWI (125 examinations) of 26 patients (age, 2-16 years) was reviewed in this study. Images were acquired of patients sedated with propofol. Reviewers classified the images by weak or strong venous contrast. Physiologic data, such as etCO(2), BP, age, and CBF by arterial spin-labeling, were monitored and collected during MR imaging. A generalized estimating equation approach was used to model associations of these parameters with venous contrast.
  
  
  RESULTS
  EtCO(2) and CBF were found to correlate with venous contrast, suggesting that patients with high etCO(2) and CBF have weak contrast and patients with low etCO(2) and CBF have strong contrast. BP was also found to correlate with the venous contrast of SWI, suggesting that patients with high BP have strong venous contrast. No significant correlations were found for any other physiologic parameters.
  
  
  CONCLUSIONS
  We found that the venous contrast in SWI is affected by propofol sedation in spontaneously breathing patients. We also found that low etCO(2), low CBF, and high BP are associated with strong venous contrast. Reviewing SWI data in light of physiologic measures may therefore help prevent potential misinterpretations of weak venous contrast in SWI examinations under propofol sedation.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sedlacik
authors.forename: U
authors.initials: U
authors.lastname: Löbel
authors.forename: M
authors.initials: M
authors.lastname: Kocak
authors.forename: R B
authors.initials: RB
authors.lastname: Loeffler
authors.forename: J R
authors.initials: JR
authors.lastname: Reichenbach
authors.forename: A
authors.initials: A
authors.lastname: Broniscer
authors.forename: Z
authors.initials: Z
authors.lastname: Patay
authors.forename: C M
authors.initials: CM
authors.lastname: Hillenbrand
mesh_terms: D000293:Adolescent; D016477:Artifacts; D002550:Cerebral Veins / Q000187:drug effects* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity
chemical_list: D015742:Propofol