MR angiography of the damaged brain in the newborn infant

This paper evaluates the choice of MR angiographic techniques during the first 2 months of life when cerebral blood flow rates are normally lower than in later infancy and childhood. Twenty-five infants (newborn to age 2 months) with cerebrovascular insults were evaluated by means of one or more MR angiographic techniques: (1) three-dimensional time of flight (3DTOF), (2) two-dimensional time of flight (2DTOF), and (3) velocity compensated-uncompensated time of flight (VCU-TOF). Studies done with and without gadolinium injection were also evaluated. 2DTOF showed better visualization of slower distal arterial flow in cortical cerebral branches than did 3DTOF or VCU-TOF. The major limitation of 2DTOF was a relatively thick (2 mm) section. 3DTOF with gadolinium enhancement also showed good cerebral cortical vasculature but required needle placement and was problematic when contrast-enhancing damaged tissue was present. VCU-TOF proved useful in subtracting out high signal intensity methemoglobin clot, such as in parenchymal hematomas or dural sinus and deep venous thrombosis