RT Journal Article
SR Electronic
T1 Cerebral Hemodynamic and Metabolic Abnormalities in Neonatal Hypocalcemia: Findings from Advanced MRI
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1224
OP 1230
DO 10.3174/ajnr.A7994
VO 44
IS 10
A1 Qi, Ying
A1 Lin, Zixuan
A1 Lu, Hanzhang
A1 Mao, Jian
A1 Zhang, Hongyang
A1 Zhao, Pengfei
A1 Hou, Yang
YR 2023
UL http://www.ajnr.org/content/44/10/1224.abstract
AB BACKGROUND AND PURPOSE: Neonatal hypocalcemia is the most common metabolic disorder, and whether asymptomatic disease should be treated with calcium supplements remains controversial. We aimed to quantify neonatal hypocalcemia’s global CBF and cerebral metabolic rate of oxygen (CMRO2) using physiologic MR imaging and elucidate the pathophysiologic vulnerabilities of neonatal hypocalcemia.MATERIALS AND METHODS: A total of 37 consecutive patients with neonatal hypocalcemia were enrolled. They were further divided into subgroups with and without structural MR imaging abnormalities, denoted as neonatal hypocalcemia-a (n = 24) and neonatal hypocalcemia-n (n = 13). Nineteen healthy neonates were enrolled as a control group. Brain physiologic parameters determined using phase-contrast MR imaging, T2-relaxation-under-spin-tagging MR imaging, and brain volume were compared between patients with neonatal hypocalcemia (their subgroups) and controls. Predictors for neonatal hypocalcemia–related brain injuries were identified using multivariate logistic regression analysis and expressed as ORs with 95% CIs.RESULTS: Patients with neonatal hypocalcemia showed significantly lower CBF and CMRO2 compared with controls. Furthermore, the neonatal hypocalcemia-a subset (versus controls or neonatal hypocalcemia-n) had significantly lower CBF and CMRO2. There was no obvious difference in CBF and CMRO2 between the neonatal hypocalcemia-n subset and controls. CBF and CMRO2 were independently associated with neonatal hypocalcemia. The ORs were 0.80 (95% CI, 0.65–0.99) and 0.97 (95% CI, 0.89–1.05) for CBF and CMRO2, respectively.CONCLUSIONS: Neonatal hypocalcemia with structural damage may exhibit lower hemodynamics and cerebral metabolism. CBF may be useful in assessing the need for calcium supplementation in asymptomatic neonatal hypocalcemia to prevent brain injury.AUCarea under the curveCMRO2cerebral metabolic rate of oxygeniCaionized calciumNHCneonatal hypocalcemiaNRDSneonatal respiratory distress syndromePCMRphase-contrast MR imagingPVWMperiventricular WMTRUSTT2-relaxation-under-spin-taggingYvvenous oxygenation