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Updated: Mar 10, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Basal ganglia perfusion using dynamic color Doppler sonography in infants with hypoxic ischemic encephalopathy
Ricardo Faingold1, Guilherme Cassia1, Linda Morneault2
1Department of Medical Imaging, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
Insights
Higher basal ganglia cerebral perfusion intensity (CPI) in infants with hypoxic-ischemic encephalopathy (HIE) undergoing hypothermia correlates with poor survival outcomes. This finding aids in predicting infant prognosis during treatment.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
- Critical care medicine
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a serious condition in newborns.
- Therapeutic hypothermia is a standard treatment for HIE.
- Assessing cerebral blood flow is crucial for predicting outcomes.
Purpose of the Study:
- To evaluate basal ganglia cerebral perfusion in HIE infants receiving hypothermia.
- To correlate dynamic color Doppler sonography (CDS) measurements with survival rates.
Main Methods:
- Head ultrasound (HUS) and dynamic color Doppler sonography (CDS) were used.
- Cerebral perfusion intensity (CPI) was measured in the basal ganglia.
- Retrospective analysis of clinical and radiological data from 28 infants.
Main Results:
- CPI measurements were significantly higher in non-survivors compared to survivors (0.226 vs. 0.111 cm/sec).
- HUS was performed within 48 hours of hypothermia initiation.
- Higher CPI indicated a poorer prognosis.
Conclusions:
- Elevated basal ganglia perfusion intensity in HIE neonates treated with hypothermia is linked to adverse outcomes.
- CPI may serve as a predictive biomarker for HIE prognosis.
Background:
The objective of this study was to evaluate the cerebral perfusion of the basal ganglia in infants with hypoxic-ischemic encephalopathy (HIE) receiving hypothermia using dynamic color Doppler sonography (CDS) and investigate for any correlation between these measurements and survival.
Methods:
Head ultrasound (HUS) was performed with a 9S4 MHz sector transducer in HIE infants submitted to hypothermia as part of their routine care. Measurements of cerebral perfusion intensity (CPI) with an 11LW4 MHz linear array transducer were performed to obtain static images and DICOM color Doppler videos of the blood flow in the basal ganglia area. Clinical and radiological data were evaluated retrospectively. The video images were analyzed by two radiologists using dedicated software, which allows automatic quantification of color Doppler data from a region of interest (ROI) by dynamically assessing color pixels and flow velocity during the heart cycle. CPI is expressed in cm/sec and is calculated by multiplying the mean velocity of all pixels divided by the area of the ROI. Three videos of 3 seconds each were obtained of the ROI, in the coronal plane, and used to calculate the CPI. Data are presented as mean ± SEM or median (quartiles).
Results:
A total of 28 infants were included in this study: 16 male, 12 female. HUS was performed within the first 48 hours of therapeutic hypothermia treatment. CPI values were significantly higher in the seven non-survivors when compared to survivors (0.226±0.221 vs. 0.111±0.082 cm/sec; P=0.02).
Conclusions:
Increased perfusion intensity of the basal ganglia area within the first 48 of therapeutic hypothermia treatment was associated with poor outcome in neonates with HIE.
