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The effects of propofol on cerebral perfusion MRI in children.

Authors :
Harreld, Julie
Helton, Kathleen
Kaddoum, Roland
Reddick, Wilburn
Li, Yimei
Glass, John
Sansgiri, Rakhee
Ji, Qing
Feng, Tianshu
Parish, Mary
Gajjar, Amar
Patay, Zoltan
Source :
Neuroradiology; Aug2013, Vol. 55 Issue 8, p1049-1056, 8p
Publication Year :
2013

Abstract

Introduction: The effects of anesthesia are infrequently considered when interpreting pediatric perfusion magnetic resonance imaging (MRI). The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors. Methods: Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8-18 years) treated for infratentorial brain tumors receiving propofol (IV, n = 19) or no sedation (NS, n = 18) were compared between groups and correlated with age, hematocrit (Hct), end-tidal CO (ETCO), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression. Results: Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater ( p = 0.03), in IV than NS patients ( p = 0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories ( r = 0.53, r = 0.47; p < 0.05). ACA and MCA CBF ( r = 0.59, 0.49; p < 0.05) and CBV in ACA, MCA, and posterior cerebral artery territories ( r = 0.73, 0.80, 0.52; p < 0.05) increased with weight in propofol-sedated children, with no significant additional influence from age, ETCO, hematocrit, or RT. Conclusion: In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00283940
Volume :
55
Issue :
8
Database :
Complementary Index
Journal :
Neuroradiology
Publication Type :
Academic Journal
Accession number :
89151654
Full Text :
https://doi.org/10.1007/s00234-013-1187-0