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Research ArticlePediatric Neuroimaging
Open Access

Elevated Cerebral Blood Volume Contributes to Increased FLAIR Signal in the Cerebral Sulci of Propofol-Sedated Children

J.H. Harreld, N.D. Sabin, M.G. Rossi, R. Awwad, W.E. Reddick, Y. Yuan, J.O. Glass, Q. Ji, A. Gajjar and Z. Patay
American Journal of Neuroradiology August 2014, 35 (8) 1574-1579; DOI: https://doi.org/10.3174/ajnr.A3911
J.H. Harreld
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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N.D. Sabin
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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M.G. Rossi
bAnesthesiology (M.G.R.)
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R. Awwad
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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W.E. Reddick
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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Y. Yuan
cBiostatistics (Y.Y.)
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J.O. Glass
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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Q. Ji
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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A. Gajjar
dOncology (A.G.), St. Jude Children's Research Hospital, Memphis, Tennessee.
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Z. Patay
aFrom the Departments of Radiological Sciences (J.H.H., N.D.S., R.A., W.E.R., J.O.G., Q.J., Z.P.)
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  • Fig 1.
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    Fig 1.

    Visual scale for grading SSI in supraventricular sulci: 0 = complete nulling, 1 = stippled hyperintensity, 2 = stippled with areas of confluent hyperintensity, 3 = confluent hyperintensity in sulci. The same grading scale was applied to precontrast and postcontrast FLAIR images.

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    Fig 2.

    Relationship of CBV with pre-contrast (A) and post-contrast (B) FLAIR SSI. Significant correlations (P < .05) are in black.

Tables

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    Table 1:

    Univariate and multivariate analyses for the effects of selected factors on pre-/postcontrast SSI, overall and for propofol subjects

    OverallPropofol
    UnivariateMultivariateaUnivariateMultivariatea
    RbPOR (95% CI)PRbPOR (95% CI)P
    Precontrast SSI
        FiO20.442.003−0.418.042
        Age−0.372.0150.523.0091.661 (0.954–2.893).073
        GM CBF0.036.8640.274.364
        GM CBV0.671.00024.127 (1.688–10.089).0020.612.0263.964 (1.118–14.054).033
        GM MTT0.461.0203.769 (1.231–11.537).0200.331.269
    Postcontrast SSI
        FiO20.453.003–.022−0.357.087
        Age−0.374.0150.600.0021.658 (0.982–2.8).058
        GM CBF0.062.7700.180.557
        GM CBV0.625.00082.613 (1.225–5.575).0130.376.205
        GM MTT0.368.0710.199.516
    • ↵a Multivariate analysis by stepwise ordinal logistic regression.

    • ↵b Spearman correlation coefficient.

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    Table 2:

    SSI, Age, and FiO2 overall and by anesthesia statusa

    Overall (n = 42)Propofol (n = 24)Awake (n = 18)Pb
    Pre-SSI
        021 (50%)6 (25%)15 (83%).0001
        112 (29%)9 (38%)3 (17%)
        28 (19%)8 (33%)0 (0%)
        31 (2%)1 (4%)0 (0%)
    Post-SSI
        05 (12%)0 (0%)5 (28%).0001
        126 (62%)13 (54%)13 (72%)
        29 (21%)9 (38%)0 (0%)
        32 (5%)2 (8%)0 (0%)
    Age (yr)9.66 (4.92)6.2 (3.3)14.3 (2.1)<.0001
    FiO20.35 (0.14)0.5 (0.1)0.2 (0)<.0001
    • ↵a Age, FiO2, given as means (SDs).

    • ↵b P value for testing differences between propofol vs awake groups.

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    Table 3:

    Perfusion measures overall and by anesthesia statusa

    Overall (n = 25)Propofol (n = 13)Awake (n = 12)Pb
    CBF (mL/min/100 g)66.86 (15.45)67.2 (17.7)66.5 (13.4).765
    CBV (mL/100 g)7.45 (1.46)8.2 (1.5)6.6 (0.8).008
    MTT (s−1)6.69 (1.12)7.2 (1)6.2 (1).013
    • ↵a CBF, CBV, and MTT given as means (SDs).

    • ↵b P value for testing differences between propofol vs awake groups.

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American Journal of Neuroradiology: 35 (8)
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J.H. Harreld, N.D. Sabin, M.G. Rossi, R. Awwad, W.E. Reddick, Y. Yuan, J.O. Glass, Q. Ji, A. Gajjar, Z. Patay
Elevated Cerebral Blood Volume Contributes to Increased FLAIR Signal in the Cerebral Sulci of Propofol-Sedated Children
American Journal of Neuroradiology Aug 2014, 35 (8) 1574-1579; DOI: 10.3174/ajnr.A3911

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Elevated Cerebral Blood Volume Contributes to Increased FLAIR Signal in the Cerebral Sulci of Propofol-Sedated Children
J.H. Harreld, N.D. Sabin, M.G. Rossi, R. Awwad, W.E. Reddick, Y. Yuan, J.O. Glass, Q. Ji, A. Gajjar, Z. Patay
American Journal of Neuroradiology Aug 2014, 35 (8) 1574-1579; DOI: 10.3174/ajnr.A3911
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