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Updated: May 11, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
The effects of propofol on cerebral perfusion MRI in children
Julie H Harreld1, Kathleen J Helton2, Roland N Kaddoum3
1Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA. julie.harreld@stjude.org.
Insights
Propofol sedation in children undergoing perfusion MRI reversed typical age-related decreases in cerebral blood flow (CBF) and cerebral blood volume (CBV). These measures increased with weight, not age, in sedated patients.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Anesthesiology
Background:
- Anesthesia effects are often overlooked in pediatric perfusion MRI interpretation.
- Understanding these effects is crucial for accurate assessment of cerebral hemodynamics in children.
Purpose of the Study:
- To compare magnetic resonance (MR) measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children.
- To identify factors influencing these MR measures, such as age, weight, and physiological parameters.
Main Methods:
- Dynamic susceptibility contrast perfusion MRI was used to measure supratentorial cortical CBF and CBV in 37 children (1.8-18 years).
- Patients received either propofol (IV) or no sedation (NS).
- Data were correlated with age, hematocrit, end-tidal CO₂, dose, weight, and radiation therapy history; multiple linear regression identified predictive models.
Main Results:
- Propofol-sedated patients showed significantly lower CBF in anterior and middle cerebral artery territories compared to non-sedated patients.
- Cerebral blood volume was greater in the MCA territory in sedated patients.
- The typical age-related decline in CBF was reversed with propofol sedation; CBF and CBV increased with weight in sedated children.
Conclusions:
- Propofol sedation alters pediatric cerebral hemodynamics, reversing age-related CBF trends and introducing weight-dependent increases in CBF and CBV.
- Weight-dependent propofol clearance may mitigate CBF and CBV suppression.
- Further prospective studies are needed to develop anesthetic-specific models for pediatric CBF and CBV assessment.
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 CO₂ (ETCO₂), 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, ETCO₂, 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.
