Brain Perfusion Is Increased at Term in the White Matter of Very Preterm Newborns and Newborns with Congenital Heart Disease: Does this Reflect Activated Angiogenesis?
OBJECTIVE
This study aims to evaluate brain perfusion at term in very preterm newborns and newborns with congenital heart disease before their corrective surgery, and to search for histopathological indicators of whether the brain perfusion abnormalities of these newborns may be related to an activated angiogenesis.


METHODS
Using magnetic resonance imaging and arterial spin labeling, regional cerebral blood flow was measured at a term-equivalent age for three very preterm newborns (born at < 32 weeks), one newborn with congenital heart disease before his corrective surgery and three healthy newborns. In addition, a histopathological analysis was performed on a newborn with congenital heart disease.


RESULTS
The very preterm newborns and the newborn with congenital heart disease included in this study all displayed an increased signal in their white matter on T2-weighted imaging. The cerebral blood flow of these newborns was increased in their white matter, compared with the healthy term newborns. The vascular endothelial growth factor was overexpressed in the injured white matter of the newborn with congenital heart disease.


CONCLUSIONS
Brain perfusion may be increased at term in the white matter, in very preterm newborns, and newborns with congenital heart disease, and it correlates with white matter abnormalities on conventional imaging.
Department of Pediatrics, McGill University, Montreal, Canada.
Pia
P
Wintermark
Department of Pathology, University of California Davis Medical Center, Sacramento, United States.
Mirna
M
Lechpammer
Department of Neurology, Boston Children's Hospital, Boston, United States.
Bela
B
Kosaras
Department of Neurology, Boston Children's Hospital, Boston, United States.
Frances E
FE
Jensen
Department of Radiology, Boston Children's Hospital, Boston, United States.
Simon K
SK
Warfield
D002540:Cerebral Cortex / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology*; D006331:Heart Diseases / Q000150:complications* / Q000151:congenital*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009389:Neovascularization, Pathologic / Q000378:metabolism*; D013113:Spin Labels; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D066127:White Matter / Q000098:blood supply* / Q000473:pathology*
D013113:Spin Labels; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A