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American Academy of Pediatrics
Article

Brain Perfusion in Children: Evolution With Age Assessed by Quantitative Perfusion Computed Tomography

Max Wintermark, Domenico Lepori, Jacques Cotting, Eliane Roulet, Guy van Melle, Reto Meuli, Philippe Maeder, Luca Regli, Francis R. Verdun, Thierry Deonna, Pierre Schnyder and François Gudinchet
Pediatrics June 2004, 113 (6) 1642-1652; DOI: https://doi.org/10.1542/peds.113.6.1642
Max Wintermark
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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Domenico Lepori
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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Jacques Cotting
‡Department of Pediatrics, University Hospital, Lausanne, Switzerland
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Eliane Roulet
‡Department of Pediatrics, University Hospital, Lausanne, Switzerland
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Guy van Melle
§Biostatistics Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland
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Reto Meuli
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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Philippe Maeder
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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Luca Regli
‖Department of Neurosurgery, University Hospital, Lausanne, Switzerland
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Francis R. Verdun
¶University Institute of Applied Radiophysics, Lausanne, Switzerland
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Thierry Deonna
‡Department of Pediatrics, University Hospital, Lausanne, Switzerland
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Pierre Schnyder
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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François Gudinchet
*Department of Diagnostic and Interventional Radiology, University Hospital, Lausanne, Switzerland
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Abstract

Objective. The objective of this study was to assess the age-related variations of brain perfusion through quantitative cerebral perfusion computed tomography (CT) results in children without brain abnormality.

Methods. Brain perfusion CT examinations were performed in 77 children, aged 7 days to 18 years. These patients were admitted at our institution for both noncontrast and contrast-enhanced cerebral CT. Only children whose conventional cerebral CT and clinical/radiologic follow-up, including additional investigations, were normal were taken into account for this study (53 of 77).

Results. The average regional rCBF amounts to 40 (mL/100 g per minute) for the first 6 months of life, peaks at ∼130 (mL/100 g per minute) at ∼2 to 4 years of age, and finally stabilizes at ∼50 (mL/100 g per minute) at ∼7 to 8 years of age, with a small increase of rCBF values at ∼12 years of age. The rCBF in the gray matter averages 3 times that in the white matter, except for the first 6 months of life. The global CBF represents 10% to 20% of the global cardiac output for the first 6 months of life, peaks at ∼55% by 2 to 4 years of age, and finally stabilizes at ∼15% by 7 to 8 years of age. Specific age-related evolution patterns were identified in the different anatomic areas of the cerebral parenchyma, which could be related to the development of neuroanatomic structures and to the emergence of corresponding cognitive functions.

Conclusions. Quantitative perfusion CT characterization of brain perfusion shows specific age variations. Brain perfusion of each cortical area evolves according to a specific time course, in close correlation with the psychomotor development.

  • child
  • brain maturation
  • brain perfusion
  • psychomotor development
  • CT
  • perfusion CT
  • Received June 2, 2003.
  • Accepted October 20, 2003.
  • Copyright © 2004 by the American Academy of Pediatrics

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Pediatrics
Vol. 113, Issue 6
1 Jun 2004
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Brain Perfusion in Children: Evolution With Age Assessed by Quantitative Perfusion Computed Tomography
Max Wintermark, Domenico Lepori, Jacques Cotting, Eliane Roulet, Guy van Melle, Reto Meuli, Philippe Maeder, Luca Regli, Francis R. Verdun, Thierry Deonna, Pierre Schnyder, François Gudinchet
Pediatrics Jun 2004, 113 (6) 1642-1652; DOI: 10.1542/peds.113.6.1642

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Brain Perfusion in Children: Evolution With Age Assessed by Quantitative Perfusion Computed Tomography
Max Wintermark, Domenico Lepori, Jacques Cotting, Eliane Roulet, Guy van Melle, Reto Meuli, Philippe Maeder, Luca Regli, Francis R. Verdun, Thierry Deonna, Pierre Schnyder, François Gudinchet
Pediatrics Jun 2004, 113 (6) 1642-1652; DOI: 10.1542/peds.113.6.1642
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Subjects

  • Radiology
    • Radiology
  • Neurology
    • Neurology

Keywords

  • child
  • brain maturation
  • brain perfusion
  • psychomotor development
  • CT
  • perfusion CT
  • MR-PWI, magnetic resonance perfusion-weighted imaging
  • CT, computed tomography
  • SPECT, single photon emission computed tomography
  • PET, positron emission tomography
  • CBF, cerebral blood flow
  • MTT, mean transit time
  • rCBV, regional cerebral blood volume
  • rCBF, regional cerebral blood flow
  • ROI, region of interest
  • BSA, body surface area
  • ANOVA, analysis of variance
  • MRI, magnetic resonance imaging
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