Article Figures & Data
Figures
- Fig 1.
Axial PASL images showing the manually drawn regions of interest. A total of 9 regions of interest were placed in 3 types of tissue. a, CGM (within frontal, parietal, and occipital cortices). b and c, WM (within the frontal and posterior WM and the centrum semiovale) (b) and BG (within the lentiform nucleus and the posterior limb of internal capsule and the thalamus) (c).15,17,24 Measurements were obtained in the right and left sides of the cerebrum in these tissue regions. Regions of interest were always drawn on the ASL data by 1 observer in similar brain areas for all the MR images by looking at the same time at the ASL data and the corresponding T2-weighted imaging.
- Fig 2.
Brain MR imaging in a control neonate; comparison between the perfusion map and images obtained from conventional sequences. A, CBF map obtained by perfusion imaging by ASL shows higher brain perfusion in GM and in BG compared with WM. B, ADC map. C, DWI. D, T2-weighted imaging.
- Fig 3.
Brain MR imaging on DOL 2 in patient 5 while he was treated with induced hypothermia; comparison between the perfusion map and images obtained from conventional sequences. A and B, CBF maps obtained by perfusion imaging by ASL show decreased brain perfusion on DOL 1 (A) followed by increased brain perfusion on DOL 2 (B) in the GM, WM, and BGs bilaterally, compared with the control patient. C and D, ADC map (C) and DWI (D) on DOL 2 display multifocal areas of restricted diffusion within bilateral BGs and both cerebral hemispheres involving GM and WM. E, Changes on T2-weighted imaging on DOL 2 are subtle.
- Fig 4.
Brain MR imaging on DOL 2 in patient 8, while he was treated with induced hypothermia; comparison between the perfusion map and images obtained from conventional sequences. A and B, CBF maps obtained by perfusion imaging by ASL show decreased brain perfusion on DOL 1 (A) followed by increased brain perfusion on DOL 2 (B) in bilateral thalami, and relatively lower perfusion in GM and the remaining BG, compared with the control patient. C and D, ADC map (C) and DWI (D) on DOL 2 display restricted diffusion within bilateral thalami. E, Changes on T2-weighted imaging on DOL 2 are subtle.
- Fig 5.
Comparison of means of CBF values in each region of interest between neonates developing brain injury in these regions of interest compared with those who did not, on DOL 1 (A) and on DOL 2–6 (B). Box-and-whisker plots (median, minimum, and maximum, in milliliters/100 g/minute) representation. The group of neonates developing brain injury is noted as the “INJURY” group, and the group of neonates who did not as “NO injury” group. The different regions of interest consist of the following: 1) CGM, including parietal CGM and remaining CGM with frontal and occipital cortical regions; 2) WM, including frontal and posterior WM and the centrum semiovale; 3) BG, including the thalamus and remaining BG with the lentiform nucleus and posterior limb of internal capsule. Dashed lines are drawn horizontally through the mean values of CBF in the CGM, WM, and BG of control neonates, to facilitate comparisons. Of note, CBF values of patient 12 are not included in the graph A, because this subject was the only asphyxiated neonate not treated with induced hypothermia; he presented with hyperperfusion on DOL 1. Patient 9 with BG injury in whom CBF was still decreased in the BG on DOL 2 is not included in the graph B because he was the only patient with persistent relative hypoperfusion on DOL 2.
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