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Cerebral Microhemorrhage: A Frequent Magnetic Resonance Imaging Finding in Pediatric Patients after Cardiopulmonary

Paggie P C Kim1, Benjamin W Nasman1, Erica L Kinne1

  • 1Department of Radiology, Section of Neuroradiology and Pediatric Radiology, Loma Linda University Medical Centre, Loma Linda, CA, USA.

Journal of Clinical Imaging Science
|August 8, 2017
PubMed
Abstract

Insights

Pediatric heart failure patients who underwent cardiopulmonary bypass (CPB) showed significantly more cerebral microhemorrhages (CM) on susceptibility-weighted imaging (SWI) compared to controls. This indicates CPB exposure increases CM prevalence and burden in this vulnerable population.

Area of Science:

  • Neurology
  • Cardiology
  • Pediatric Medicine

Background:

  • Cerebral microhemorrhage (CM) is a potential complication in patients with heart disease.
  • Susceptibility-weighted imaging (SWI) is a sensitive magnetic resonance (MR) technique for detecting CM.

Purpose of the Study:

  • To estimate the incidence and burden of CM in pediatric patients with heart failure who underwent cardiopulmonary bypass (CPB).
  • To compare CM prevalence between pediatric heart failure patients with and without CPB exposure.

Main Methods:

  • Retrospective review of MR imaging (MRI) in 86 pediatric patients with heart failure.
  • Nested case-control study comparing 23 patients with CPB exposure to 13 controls without CPB history.
  • CM detection and counting on SWI by three radiologists; statistical analysis using Mann-Whitney U-test and ANOVA.

Main Results:

  • A statistically significant difference in CM on SWI was observed between the CPB group and the control group.
  • The CPB group exhibited a higher number of CM compared to the control group, even after adjusting for age at MRI (P < 0.001).

Conclusions:

  • Cardiopulmonary bypass (CPB) exposure is associated with an increased prevalence and burden of cerebral microhemorrhages (CM).
  • These findings highlight a significant neurological risk associated with CPB in pediatric patients with heart failure.
Keywords:
Cardiopulmonary bypasscerebral microhaemorrhagepaediatricsusceptibility-weighted-imaging

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