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Brain perfusion in children: evolution with age assessed by quantitative perfusion computed tomography
Max Wintermark1, Domenico Lepori, Jacques Cotting
1Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland. max_wintermark@hotmail.com
Insights
Brain perfusion in children changes significantly with age, as shown by quantitative perfusion CT. These age-related patterns correlate with brain development and emerging cognitive functions.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Assessing pediatric brain development is crucial for understanding neurological maturation.
- Quantitative cerebral perfusion computed tomography (CT) offers a method to evaluate brain blood flow.
Purpose of the Study:
- To analyze age-related changes in brain perfusion using quantitative CT in healthy children.
- To establish normative data for brain perfusion across different pediatric age groups.
Main Methods:
- Brain perfusion CT scans were performed on 77 children aged 7 days to 18 years.
- A subset of 53 children with normal conventional CT and clinical follow-up were included.
- Quantitative parameters like regional cerebral blood flow (rCBF) and global cerebral blood flow (gCBF) were measured.
Main Results:
- Regional cerebral blood flow (rCBF) varied significantly with age, peaking between 2-4 years and stabilizing by 7-8 years.
- Gray matter rCBF was approximately three times higher than white matter rCBF after the first six months.
- Global cerebral blood flow (gCBF) as a percentage of cardiac output peaked at 2-4 years and stabilized by 7-8 years.
Conclusions:
- Quantitative perfusion CT reveals distinct age-specific patterns of brain perfusion in children.
- These perfusion patterns are closely linked to neuroanatomic development and psychomotor maturation.
Objective:
The objective of this study was to assess the age-related variations of brain perfusion through quantitative cerebral perfusion computed tomography (CT) results in children without brain abnormality.
Methods:
Brain perfusion CT examinations were performed in 77 children, aged 7 days to 18 years. These patients were admitted at our institution for both noncontrast and contrast-enhanced cerebral CT. Only children whose conventional cerebral CT and clinical/radiologic follow-up, including additional investigations, were normal were taken into account for this study (53 of 77).
Results:
The average regional rCBF amounts to 40 (mL/100 g per minute) for the first 6 months of life, peaks at approximately 130 (mL/100 g per minute) at approximately 2 to 4 years of age, and finally stabilizes at approximately 50 (mL/100 g per minute) at approximately 7 to 8 years of age, with a small increase of rCBF values at approximately 12 years of age. The rCBF in the gray matter averages 3 times that in the white matter, except for the first 6 months of life. The global CBF represents 10% to 20% of the global cardiac output for the first 6 months of life, peaks at approximately 55% by 2 to 4 years of age, and finally stabilizes at approximately 15% by 7 to 8 years of age. Specific age-related evolution patterns were identified in the different anatomic areas of the cerebral parenchyma, which could be related to the development of neuroanatomic structures and to the emergence of corresponding cognitive functions.
Conclusions:
Quantitative perfusion CT characterization of brain perfusion shows specific age variations. Brain perfusion of each cortical area evolves according to a specific time course, in close correlation with the psychomotor development.
