Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study
Abstract Objective The preterm brain is susceptible to structural injuries, which may be related to an imbalance between blood supply and oxygen metabolism. However, the effect of preterm birth on cerebral oxygen metabolism and its underlying mechanism have not been fully elucidated. The present stu...
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Wiley
2024-12-01
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| Series: | Annals of the Child Neurology Society |
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| Online Access: | https://doi.org/10.1002/cns3.20081 |
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| author | Zixuan Lin Dan Wu Dengrong Jiang Hanzhang Lu Ying Qi |
| author_facet | Zixuan Lin Dan Wu Dengrong Jiang Hanzhang Lu Ying Qi |
| author_sort | Zixuan Lin |
| collection | DOAJ |
| description | Abstract Objective The preterm brain is susceptible to structural injuries, which may be related to an imbalance between blood supply and oxygen metabolism. However, the effect of preterm birth on cerebral oxygen metabolism and its underlying mechanism have not been fully elucidated. The present study measured cerebral oxygen extraction and metabolism using noncontrast magnetic resonance imaging (MRI) methods in preterm neonates and examined its relationship with anemia of prematurity. Methods Fifty neonates with a gestational age of 28–42 weeks were enrolled. Cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) were measured with T2‐relaxation‐under‐spin‐tagging (TRUST) MRI, together with cerebral blood flow (CBF). Results We showed that CBF (p = 0.00021) and CMRO2 (p < 0.0001) increased with gestational age while OEF increased with postnatal age (p = 0.0013). Higher OEF was also associated with a higher Apgar score at birth (p = 0.039). Furthermore, hematocrit significantly mediates the increase of OEF with postnatal age (p < 0.001). Structural equation modeling analysis suggested a bidirectional relationship between CBF and CMRO2; both contributed to the changes in OEF. Interpretation These findings demonstrated an altered cerebral oxygen metabolism in preterm brain, suggesting a potential role of MRI–based oxygenation measurement in the assessment of transfusion and intervention for preterm neonates. |
| format | Article |
| id | doaj-art-4a3354c6145e4622a8a9dcc933e8399a |
| institution | OA Journals |
| issn | 2831-3267 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of the Child Neurology Society |
| spelling | doaj-art-4a3354c6145e4622a8a9dcc933e8399a2025-08-20T01:58:43ZengWileyAnnals of the Child Neurology Society2831-32672024-12-012426928010.1002/cns3.20081Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI studyZixuan Lin0Dan Wu1Dengrong Jiang2Hanzhang Lu3Ying Qi4Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science Zhejiang University Hangzhou ChinaKey Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science Zhejiang University Hangzhou ChinaThe Russell H. Morgan Department of Radiology & Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland USAThe Russell H. Morgan Department of Radiology & Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Radiology Shengjing Hospital of China Medical University Shenyang ChinaAbstract Objective The preterm brain is susceptible to structural injuries, which may be related to an imbalance between blood supply and oxygen metabolism. However, the effect of preterm birth on cerebral oxygen metabolism and its underlying mechanism have not been fully elucidated. The present study measured cerebral oxygen extraction and metabolism using noncontrast magnetic resonance imaging (MRI) methods in preterm neonates and examined its relationship with anemia of prematurity. Methods Fifty neonates with a gestational age of 28–42 weeks were enrolled. Cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) were measured with T2‐relaxation‐under‐spin‐tagging (TRUST) MRI, together with cerebral blood flow (CBF). Results We showed that CBF (p = 0.00021) and CMRO2 (p < 0.0001) increased with gestational age while OEF increased with postnatal age (p = 0.0013). Higher OEF was also associated with a higher Apgar score at birth (p = 0.039). Furthermore, hematocrit significantly mediates the increase of OEF with postnatal age (p < 0.001). Structural equation modeling analysis suggested a bidirectional relationship between CBF and CMRO2; both contributed to the changes in OEF. Interpretation These findings demonstrated an altered cerebral oxygen metabolism in preterm brain, suggesting a potential role of MRI–based oxygenation measurement in the assessment of transfusion and intervention for preterm neonates.https://doi.org/10.1002/cns3.20081anemiacerebral blood flowcerebral oxygen metabolismoxygen extraction fractionpretermTRUST MRI |
| spellingShingle | Zixuan Lin Dan Wu Dengrong Jiang Hanzhang Lu Ying Qi Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study Annals of the Child Neurology Society anemia cerebral blood flow cerebral oxygen metabolism oxygen extraction fraction preterm TRUST MRI |
| title | Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study |
| title_full | Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study |
| title_fullStr | Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study |
| title_full_unstemmed | Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study |
| title_short | Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study |
| title_sort | altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia a noncontrast mri study |
| topic | anemia cerebral blood flow cerebral oxygen metabolism oxygen extraction fraction preterm TRUST MRI |
| url | https://doi.org/10.1002/cns3.20081 |
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