title: Impaired Global and Regional Cerebral Perfusion in Newborns with Complex Congenital Heart Disease.
abstract: OBJECTIVE
  To compare global and regional cerebral perfusion in newborns with congenital heart disease (CHD) and healthy controls using arterial spin labeling (ASL) magnetic resonance imaging (MRI) prior to open heart surgery.
  
  
  METHODS
  We performed brain MRIs in 101 newborns (58 controls, 43 CHD) using 3-dimensional fast spin echo pseudo-continuous ASL. Cerebral blood flow (CBF) ASL images were linearly coregistered to T2-weighted images for anatomic delineation and selection of regions-of-interest. Anatomic regions included frontal white matter (FWM), occipital white matter (OWM), thalami, and basal ganglia (BG).
  
  
  RESULTS
  Newborns with single ventricle CHD demonstrated significantly lower global (P = .044) and regional BG (P = .025) CBF compared with controls. Mean regional CBF in the thalami in cyanotic newborns with CHD was lower compared with controls (P = .004). Mean regional CBF in thalami (P = .02), BG (P = .01), and OWM (P = .03) among newborns with cyanotic CHD was lower than those with acyanotic CHD. Newborns with CHD ventilated prior to MRI had increased global (P = .016) and OWM (P = .013) CBF compared with those not ventilated.
  
  
  CONCLUSIONS
  Newborns with uncorrected cyanotic or single ventricle CHD show disturbances in cerebral perfusion compared to healthy controls using ASL. Cardiac physiology and preoperative hemodynamic compromise play an important role in preoperative alterations in global and regional cerebral perfusion. Our data suggest that ASL may be useful for studying cerebral perfusion in newborns at high risk for cerebral ischemia, such as those with complex CHD.
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Usha D
authors.initials: UD
authors.lastname: Nagaraj
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Iordanis E
authors.initials: IE
authors.lastname: Evangelou
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC; Department of Cardiology, Children's National Medical Center, Washington, DC; Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Donofrio
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: L Gilbert
authors.initials: LG
authors.lastname: Vezina
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC; Department of Epidemiology and Biostatistics, Children's National Medical Center, Washington, DC.
authors.forename: Robert
authors.initials: R
authors.lastname: McCarter
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC; Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC.
authors.forename: Adre J
authors.initials: AJ
authors.lastname: du Plessis
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC. Electronic address: climpero@childrensnational.org.
authors.forename: Catherine
authors.initials: C
authors.lastname: Limperopoulos
mesh_terms: D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D002545:Brain Ischemia / Q000473:pathology; D006348:Cardiac Surgical Procedures; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000150:complications; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008423:Maternal Age; D011446:Prospective Studies; D012306:Risk; D013113:Spin Labels
chemical_list: D013113:Spin Labels