A uniform description of perioperative brain MRI findings in infants with severe congenital heart disease: Results of a European collaboration

for the European Association Brain in Congenital Heart Disease Consortium

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: A uniform description of brain MR imaging findings in infants with severe congenital heart disease to assess risk factors, predict outcome, and compare centers is lacking. Our objective was to uniformly describe the spectrum of perioperative brain MR imaging findings in infants with congenital heart disease. MATERIALS AND METHODS: Prospective observational studies were performed at 3 European centers between 2009 and 2019. Brain MR imaging was performed preoperatively and/or postoperatively in infants with transposition of the great arteries, single-ventricle physiology, or left ventricular outflow tract obstruction undergoing cardiac surgery within the first 6 weeks of life. Brain injury was assessed on T1, T2, DWI, SWI, and MRV. A subsample of images was assessed jointly to reach a consensus. RESULTS: A total of 348 MR imaging scans (180 preoperatively, 168 postoperatively, 146 pre- and postoperatively) were obtained in 202 infants. Preoperative, new postoperative, and cumulative postoperative white matter injury was identified in 25%, 30%, and 36%; arterial ischemic stroke, in 6%, 10%, and 14%; hypoxic-ischemic watershed injury in 2%, 1%, and 1%; intraparenchymal cerebral hemorrhage, in 0%, 4%, and 5%; cerebellar hemorrhage, in 6%, 2%, and 6%; intraventricular hemorrhage, in 14%, 6%, and 13%; subdural hemorrhage, in 29%, 17%, and 29%; and cerebral sinovenous thrombosis, in 0%, 10%, and 10%, respectively. CONCLUSIONS: A broad spectrum of perioperative brain MR imaging findings was found in infants with severe congenital heart disease. We propose an MR imaging protocol including T1-, T2-, diffusion-, and susceptibility-weighted imaging, and MRV to identify ischemic, hemorrhagic, and thrombotic lesions observed in this patient group.

Original languageEnglish
JournalAmerican Journal of Neuroradiology
Volume42
Issue number11
DOIs
Publication statusPublished - 1 Nov 2021
Externally publishedYes

Bibliographical note

Funding Information:
This research was funded by a Consolidator Grant of the European Society of Pediatric Research. It was also funded by the Hartekind Foundation and Vrienden van het Wilhelmina Kinderziekenhuis Foundation; the Medical Research Council UK (MR/L011530/1); the British Heart Foundation (FS/15/55/31649); the Action Medical Research (GN2630); the Wellcome Engineering and Physical Sciences Research Council Center for Medical Engineering at King?s College London (WT 203148/Z/16/Z); and the M?xiFoundation, the Anna M?ller Grocholski Foundation, and the EMDO Foundation Zurich.

Funding Information:
This research was funded by a Consolidator Grant of the European Society of Pediatric Research. It was also funded by the Hartekind Foundation and Vrienden van het Wilhelmina Kinderziekenhuis Foundation; the Medical Research Council UK (MR/ L011530/1); the British Heart Foundation (FS/15/55/31649); the Action Medical Research (GN2630); the Wellcome Engineering and Physical Sciences Research Council Center for Medical Engineering at King’s College London (WT 203148/Z/16/Z); and the Mäx-iFoundation, the Anna Müller Grocholski Foundation, and the EMDO Foundation Zurich.

Publisher Copyright:
Copyright 2021 by American Society of Neuroradiology.

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