title: The effects of propofol on cerebral perfusion MRI in children.
abstract: BACKGROUND
  The effects of anesthesia are infrequently considered when interpreting pediatric perfusion magnetic resonance imaging (MRI). The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors.
  
  
  METHODS
  Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8-18 years) treated for infratentorial brain tumors receiving propofol (IV, n = 19) or no sedation (NS, n = 18) were compared between groups and correlated with age, hematocrit (Hct), end-tidal CO₂ (ETCO₂), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression.
  
  
  RESULTS
  Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater (p = 0.03), in IV than NS patients (p = 0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories (r = 0.53, r = 0.47; p < 0.05). ACA and MCA CBF (r = 0.59, 0.49; p < 0.05) and CBV in ACA, MCA, and posterior cerebral artery territories (r = 0.73, 0.80, 0.52; p < 0.05) increased with weight in propofol-sedated children, with no significant additional influence from age, ETCO₂, hematocrit, or RT.
  
  
  CONCLUSIONS
  In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA. julie.harreld@stjude.org.
authors.forename: Julie H
authors.initials: JH
authors.lastname: Harreld
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Helton
authors.affiliation: Department of Anesthesiology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Roland N
authors.initials: RN
authors.lastname: Kaddoum
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Wilburn E
authors.initials: WE
authors.lastname: Reddick
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Yimei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: John O
authors.initials: JO
authors.lastname: Glass
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Rakhee
authors.initials: R
authors.lastname: Sansgiri
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Ji
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Feng
authors.affiliation: Department of Anesthesiology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Mary Edna
authors.initials: ME
authors.lastname: Parish
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Amar
authors.initials: A
authors.lastname: Gajjar
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Patay
mesh_terms: D000293:Adolescent; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001783:Blood Flow Velocity / Q000187:drug effects; D001810:Blood Volume / Q000187:drug effects*; D001921:Brain; D002536:Cerebral Arteries / Q000187:drug effects / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol