Noninvasive cerebral perfusion imaging in high-risk neonates
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Updated: Jun 16, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Donna A Goff1, Erin M Buckley, Turgut Durduran
1Department of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Insights
High-risk neonates face neurodevelopmental challenges. New noninvasive methods like arterial spin-labeled MRI and diffuse correlation spectroscopy offer direct measurement of cerebral blood flow (CBF), improving neurological assessment.
Area of Science:
- Neonatal care and neurology
- Medical imaging techniques
- Cerebral blood flow dynamics
Background:
- Neonatal survival has increased, but neurodevelopmental delays remain a concern.
- Assessing cerebral oxygenation and cerebral blood flow (CBF) is crucial for neurological evaluation in high-risk neonates.
- Conventional CBF imaging methods are ethically and logistically challenging for neonates.
Purpose of the Study:
- To review noninvasive imaging techniques for measuring cerebral blood flow (CBF) in high-risk neonates.
- To discuss the instrumentation, applications, and limitations of emerging CBF measurement modalities.
- To highlight advancements beyond traditional methods like near-infrared spectroscopy (NIRS).
Main Methods:
- Discussion of optical near-infrared spectroscopy (NIRS) for monitoring cerebral oxygenation and blood volume.
- Introduction of arterial spin-labeled perfusion magnetic resonance imaging (ASL-MRI) as a direct CBF measurement tool.
- Evaluation of optical diffuse correlation spectroscopy (DCS) for noninvasive cerebral perfusion assessment.
Main Results:
- NIRS provides indirect trends of CBF but not direct measurements.
- ASL-MRI and DCS offer direct, noninvasive quantification of cerebral perfusion in neonates.
- These novel techniques are suitable for bedside monitoring in vulnerable infant populations.
Conclusions:
- Arterial spin-labeled perfusion MRI and diffuse correlation spectroscopy are promising noninvasive tools for direct CBF measurement in high-risk neonates.
- These methods overcome limitations of traditional techniques and NIRS for precise neurological assessment.
- Further research and clinical application of these advanced imaging modalities are warranted.
Abstract:
Advances in medical and surgical care of the high-risk neonate have led to increased survival. A significant number of these neonates suffer from neurodevelopmental delays and failure in school. The focus of clinical research has shifted to understanding events contributing to neurological morbidity in these patients. Assessing changes in cerebral oxygenation and regulation of cerebral blood flow (CBF) is important in evaluating the status of the central nervous system. Traditional CBF imaging methods fail for both ethical and logistical reasons. Optical near infrared spectroscopy (NIRS) is increasingly being used for bedside monitoring of cerebral oxygenation and blood volume in both very low birth weight infants and neonates with congenital heart disease. Although trends in CBF may be inferred from changes in cerebral oxygenation and/or blood volume, NIRS does not allow a direct measure of CBF in these populations. Two relatively new modalities, arterial spin-labeled perfusion magnetic resonance imaging and optical diffuse correlation spectroscopy, provide direct, noninvasive measures of cerebral perfusion suitable for the high-risk neonates. Herein we discuss the instrumentation, applications, and limitations of these noninvasive imaging techniques for measuring and/or monitoring CBF.
