Brain volumetrics, regional cortical thickness and radiographic findings in children with cyanotic congenital heart disease using quantitative magnetic resonance imaging

Hypoxia in children with cyanotic congenital heart disease may cause structural brain changes. Objectives: 1. To assess brain volumetrics and ischemic brain lesions in children with cyanotic congenital heart disease using quantitative MRI. 2. To study the correlation between MRI findings, oxygen saturations and some laboratory measures. Participants and methods: Fifty children with CCHD and a mean oxygen saturation of 83 +- 2.2% were investigated using quantitative MRI. Brain volumetric results were compared with 20 controls. Results: Dilated Ventricles were found in 14 cases (28%). 23 cases (46%) had PWM hyperintensity. The common sites for DWML were sub-cortical that was detected in 17 cases (34%). Sub-cortical lacunar infarcts in GM were found in 8 cases (16%). Significant WM and GM volume loss was found in cyanosed subjects. The volumes of the thalamus ((ρ= 0.01), putamen (ρ= 0.003), and caudate ((ρ= 0.042) were significantly reduced in the cyanotic group. Local regions of decreased cortical thickness were detected in frontal, parietal and temporal lobes. Conclusions: Children with CCHD show MRI evidence of micro- and macro vascular injury, reduced brain volume and cortical thickness. Brain volume loss correlated with hsCRP, oxygen saturation and packed cell volume