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Updated: Jul 2, 2026
Human Fetal Blood Flow Quantification with Magnetic Resonance Imaging and Motion Compensation
Published on: January 7, 2021
Magnetic resonance imaging for quantitative flow measurement in infants with hydrocephalus: a prospective study
Paul H Leliefeld1, Rob H J M Gooskens, Koen L Vincken
1Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands. leliefeld@umcutrecht.nl
Insights
Quantitative MR angiography can measure cerebral blood flow (CBF) in infants with hydrocephalus. This study found that high intracranial pressure (ICP) reduced CBF, which improved after cerebrospinal fluid diversion.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Medical Imaging
Background:
- Raised intracranial pressure (ICP) in infants with hydrocephalus can cause cerebral hemodynamic changes and ischemia.
- Clinical signs of elevated ICP are often unreliable in infants, making surgical timing difficult.
- ICP may not correlate with ventricle size or clinical symptoms, especially with closed sutures.
Purpose of the Study:
- To investigate the use of quantitative MR angiography for measuring cerebral blood flow (CBF) in infants with progressive hydrocephalus.
- To assess the relationship between CBF and ICP before and after cerebrospinal fluid (CSF) diversion.
Main Methods:
- Fifteen infants (1 day-7 months) with progressive hydrocephalus were studied.
- Measurements included anterior fontanel pressure, MR angiography, and mean arterial blood pressure, taken before and after CSF diversion.
- Brain volume was measured for CBF compensation during infant brain maturation.
Main Results:
- Preoperative ICP averaged 19.1 cm H2O, decreasing significantly to 6.7 cm H2O post-surgery (p < 0.005).
- Preoperative CBF averaged 25.7 ml/100 cm3 brain/min, increasing significantly to 50.1 ml/100 cm3 brain/min after CSF diversion (p < 0.005).
- Mean arterial blood pressure remained unchanged post-intervention.
Conclusions:
- Quantitative MR angiography is a viable method for measuring CBF in infants with hydrocephalus.
- Elevated ICP is associated with reduced CBF in these patients.
- CSF diversion effectively improved both CBF and ICP to normal ranges.
Object:
Raised intracranial pressure (ICP) that is associated with hydrocephalus may lead to alterations in cerebral hemodynamics and ischemic changes in the brain. In infants with hydrocephalus, defining the right moment for surgical intervention based on clinical signs alone can sometimes be a difficult task. Clinical signs of raised ICP are known to be unreliable and sometimes even misleading. Furthermore, when sutures are closed, ICP does not always correlate with the size of the ventricles or with the clinical signs or symptoms. In this study the authors investigated whether cerebral blood flow (CBF) can be measured by using quantitative MR angiography in infants with progressive hydrocephalus. In addition, the authors investigated the relationship between CBF and ICP, before and after cerebrospinal fluid (CSF) diversion.
Methods:
Fifteen infants with progressive hydrocephalus (age range 1 day-7 months) were examined. All patients underwent anterior fontanel pressure measurement, MR angiography, and mean arterial blood pressure measurements before and after CSF diversion. Brain volume was measured to compensate for the physiological increase in CBF during brain maturation in infants.
Results:
The mean preoperative ICP was 19.1 +/- 8.4 cm H(2)O (+/- standard deviation). The mean postoperative ICP was 6.7 +/- 4.0 cm H(2)O (p < 0.005). The mean preoperative CBF was 25.7 +/- 11.3 ml/100 cm(3) brain/min. After CSF diversion, CBF increased to 50.1 +/- 12.1 ml/100 cm(3) brain/min (p < 0.005). The mean arterial blood pressure did not change after surgical intervention.
Conclusions:
Magnetic resonance imaging can be used to measure CBF in infants with hydrocephalus. Raised ICP was related to a decrease in CBF. After CSF diversion, CBF and ICP improved to values within the normal range.
