title: Basal ganglia perfusion using dynamic color Doppler sonography in infants with hypoxic ischemic encephalopathy receiving therapeutic hypothermia: a pilot study.
abstract: BACKGROUND
  The objective of this study was to evaluate the cerebral perfusion of the basal ganglia in infants with hypoxic-ischemic encephalopathy (HIE) receiving hypothermia using dynamic color Doppler sonography (CDS) and investigate for any correlation between these measurements and survival.
  
  
  METHODS
  Head ultrasound (HUS) was performed with a 9S4 MHz sector transducer in HIE infants submitted to hypothermia as part of their routine care. Measurements of cerebral perfusion intensity (CPI) with an 11LW4 MHz linear array transducer were performed to obtain static images and DICOM color Doppler videos of the blood flow in the basal ganglia area. Clinical and radiological data were evaluated retrospectively. The video images were analyzed by two radiologists using dedicated software, which allows automatic quantification of color Doppler data from a region of interest (ROI) by dynamically assessing color pixels and flow velocity during the heart cycle. CPI is expressed in cm/sec and is calculated by multiplying the mean velocity of all pixels divided by the area of the ROI. Three videos of 3 seconds each were obtained of the ROI, in the coronal plane, and used to calculate the CPI. Data are presented as mean ± SEM or median (quartiles).
  
  
  RESULTS
  A total of 28 infants were included in this study: 16 male, 12 female. HUS was performed within the first 48 hours of therapeutic hypothermia treatment. CPI values were significantly higher in the seven non-survivors when compared to survivors (0.226±0.221vs. 0.111±0.082 cm/sec; P=0.02).
  
  
  CONCLUSIONS
  Increased perfusion intensity of the basal ganglia area within the first 48 of therapeutic hypothermia treatment was associated with poor outcome in neonates with HIE.
authors.affiliation: Department of Medical Imaging, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Faingold
authors.affiliation: Department of Medical Imaging, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Cassia
authors.affiliation: Department of Pediatrics, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Morneault
authors.affiliation: Department of Medical Imaging, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Saint-Martin
authors.affiliation: Department of Pediatrics, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Sant'Anna
keywords: Hypoxic-ischemic encephalopathy (HIE); color Doppler sonography (CDS); head ultrasound (HUS); hypothermia; infants