Article Figures & Data
Figures
- FIG 1.
Sample images for CBF and Yv determination. A, Positioning of the imaging section. B and C, PCMR imaging section locations for the LICA, RICA, LVA, and RVA on the MIP image of a TOF angiogram. D, The manual delineation of LICA, RICA, LVA, and RVA was conducted to determine flux in these vessels. The sum of fluxes by brain weight yielded the CBF. E, The imaging section was positioned parallel to the intercommissural line with a 10-mm distance from the superior sagittal sinus (SSS). TRUST MR imaging used a spin-labeling module to isolate pure venous blood signals in the SSS. F, Blood signals from the SSS were fitted to a monoexponential function of the effective TE to yield blood T2. T2 was converted to Yv via a calibration plot. LICA indicates left internal carotid arteries; RICA, right internal carotid arteries; LVA, left vertebral artery; RVA, right vertebral artery; AU, arbitrary unit.
- FIG 2.
Flow chart of study participants.
- FIG 3.
NHC-a subgroup with brain injuries on T1WI and T2WI. A and B, Neonate (scan age, 33.3 weeks; birth weight, 1740 g; male) had focal PVWM lesions (grade I) in the right PVWM area showing increased signal intensity on T1WI and decreased signal intensity on T2WI. C and D, Neonate (scan age, 34.3 weeks; birth weight, 2600 g; male) had PVWM lesions (grade II) in the bilateral PVWM areas, linearly displaying increased signal intensity on T1WI and decreased signal intensity on T2WI. E and F, Neonate (scan age, 37.7 weeks; birth weight, 2200 g; female) had clustered PVWM lesions and cystic lesions (grade IV) in bilateral PVWM areas.
- FIG 4.
Boxplots of the physiologic parameters in both groups and subgroups. A–D, Boxplots display Yv, CBF, CMRO2, and brain volume from both groups and subgroups. NHC neonates and the NHC-a subset (versus controls) both had significantly lower CBF (P = .03, P = .001) and CMRO2 (P = .02, P = .002). CBF and CMRO2 were significantly lower in NHC-a (versus the NHC-n) (P = .001, P = .01). There was no significant difference in CBF and CMRO2 between those with NHC-n and controls (P = .70, P = .63). Yv and brain volume were not significantly different between groups (P > .05). The asterisk indicates P < .05.
- FIG 5.
Receiver operating characteristic curve for the combined values together versus a single value (CBF, CMRO2, brain volume, or iCa levels, respectively) to analyze the association between NHC and brain injuries. The combined values together versus a single value showed superior capacity to detect NHC with brain injuries (AUC= 0.92 [95% CI, 0.83-0.99]) versus CBF (AUC = 0.82 [95% CI, 0.69-0.96]; P = .001), CMRO2 (AUC = 0.73 [95% CI, 0.56-0.90]; P = .02), brain volume (AUC = 0.53 [95% CI, 0.35-0.72]; P = .82), Yv (AUC = 0.52 [95% CI, 0.32-0.72]; P = .82), or iCa levels (AUC = 0.62 [95% CI, 0.44-0.80]; P = .23).
Tables
NHC (n = 37) NHC-a (n = 24) NHC-n (n = 13) Control (n = 19) PNHC & Control Value Demographics Males (No.) (%) 24 (64.9) 14 (58.3) 7 (53.8) 14 (73.7) .11 Birth weight (mean) (g) 2024.9 (SD, 614.5) 2080.8 (SD, 532.1) 1676.5 (SD, 695.9) 2434.7 (SD, 1047.5) .13 Scan age (mean) (wk) 37.0 (SD, 2.9) 37.2 (SD, 3.2) 36.0 (SD, 1.8) 37.0 (SD, 4.0) .99 Clinical Apgar score (mean) 1 min 7.6 (SD, 3.2) 7.0 (SD, 3.5) 9.4 (SD, 0.5) 9.6 (SD, 0.8) <.05 5 min 6.2 (SD, 3.3) 5.5 (SD, 3.5) 8.0 (SD, 1.3) 8.6 (SD, 2.1) <.05 NRDS (No.) (%) 16 (43.2) 13 (54.2) 3 (23.1) – – Twins (No.) (%) 6 (16.2) 5 (20.8) 1 (7.7) – – iCa (mean) (mmol/L) 0.9 (SD, 0.2) 0.9 (SD, 0.2) 0.8 (SD, 0.1) 1.2 (SD, 0.1) <.05 Note:—The en dash indicates none.
Characteristics of Neonatal MR Imaging NHC (n = 37) NHC-a (n = 24) Periventricular WM lesions I (No.) (%) 6 (16.2) 6 (25) Periventricular WM lesions II +0 (No.) (%) 4 (10.8) 4 (16.7) + Intraventricular hemorrhage (No.) (%) 1 (2.7) 1 (4.2) Periventricular white matter lesions III (No.) (%) 1 (2.7) 1 (4.2) Periventricular white matter lesions IV (No.) (%) 7 (18.9) 7 (29.2) SAH without parenchymal hemorrhagic lesions (No.) (%) 5 (13.5) 5 (20.8) - Table 3:
Comparison of physiologic parameters between groups and their subgroups (n = 56)a
Comparators Yv (%) CBF (mL/100g/min) CMRO2 (mL/100g/min) Brain Volume (mL) NHC group (n = 37) 63.4 (SD, 13.6) 13.3 (SD, 5.3) 31.1 (SD, 12.2) 300.0 (SD, 88.6) Control group (n = 19) 64.7 (SD, 7.1) 16.5 (SD, 4.7) 40.4 (SD, 14.8) 290.4 (SD, 72.8) P value .64 <.05 <.05 .69 NHC-a group (n = 24) 63.2 (SD, 16.1) 11.2 (SD, 4.5) 27.4 (SD, 10.7) 296.9 (SD, 87.3) NHC-n group (n = 13) 63.8 (SD, 7.5) 17.1 (SD, 4.7) 37.9 (SD, 12.1) 305.6 (SD, 94.2) P value .88 <.05 <.05 .78 NHC-a group (n = 24) 63.2 (SD, 16.1) 11.2 (SD, 4.5) 27.4 (SD, 10.7) 296.9 (SD, 87.3) Control group (n = 19) 64.7 (SD, 7.1) 16.5 (SD, 4.7) 40.4 (SD, 14.8) 290.4 (SD, 72.8) P value .70 <.05 <.05 .80 NHC-n group (n = 13) 63.8 (SD, 7.5) 17.1 (SD, 4.7) 37.9 (SD, 12.1) 305.6 (SD, 94.2) Control group (n = 19) 64.7 (SD, 7.1) 16.5 (SD, 4.7) 40.4 (SD, 14.8) 290.4 (SD, 72.8) P value .73 .70 .63 .61 ↵a Data are expressed as means. P values are based on the Wilcoxon 2-sample exact test.
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