The impact of different types of brain injuries on cerebral perfusion in preterm infants: an arterial spin labeling

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Cerebral blood flow (CBF) is crucial for supplying the brain with the oxygen and nutrients necessary for its proper development and metabolism. The poor autoregulation of CBF is believed to play a role in the development of brain injury in preterm infants. This study aimed to investigate the characteristics of CBF in perinatal brain injury. In this retrospective study, 108 healthy preterm infants (HP), 26 infants with intracranial hemorrhage (IVH), and 16 infants with periventricular leukomalacia (PVL) were included. CBF was assessed using arterial spin labeling imaging in the frontal, temporal, parietal, and occipital cortex, as well as the basal ganglia and thalamus. After adjusting for gestational age, postmenstrual age (PMA) at MRI scan, and birth weight, the PVL hemispheres exhibited consistently reduced CBF in various gray matter regions compared to the HP and IVH hemispheres, including the frontal, temporal, parietal, and occipital cortex, as well as the basal ganglia and thalamus. The comparison of HP and IVH hemispheres revealed decreased CBF in IVH hemispheres in the frontal, parietal, occipital cortex, as well as in the basal ganglia and thalamus. In multifactor linear regression models, the PMA at MRI scan, 5 min Apgar score, brain injury, and neonatal necrotizing stage ≥ 2 are independent factors affecting cerebral perfusion.

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