Journal of Ultrasound in Medicine, Vol 6, Issue 9 497-507, Copyright © 1987 by American Institute of Ultrasound in Medicine
Regional cerebral blood velocity in infants. A real-time transcranial and fontanellar pulsed Doppler study
T. N. Raju and E. Zikos
Department of Pediatrics, University of Illinois College of Medicine, Chicago.
To quantitate blood velocity while maintaining the real-time ultrasound
image of the intracranial vessels in infants, we used a commercial
phased-array pulsed Doppler scanner and developed a transcranial technique
to measure the middle cerebral artery velocity, and a fontanellar approach
to measure flow velocities in the basilar, internal carotid, anterior
cerebral, and the pericallosal arteries. In 22 healthy term and 25 stable
preterm infants, the peak spectral systolic velocities in the internal
carotid and basilar arteries in term infants were 45 +/- 3.1, and 38.8 +/-
2.5 cm/sec, (mean +/- SEM), respectively. A hierarchical pattern of
velocity variation was noted between the large and small intracranial
vessels in both the term and preterm infants. The velocities were 30-40%
higher in the proximal than in the smaller distal, anterior cerebral, and
pericallosal arteries (P less than 0.05). Although the velocities in
corresponding vessels were slightly lower in preterm infants than in the
term, the differences were statistically not significant. In both groups,
the end diastolic velocities did not change significantly among the large
and small arteries; therefore, a significant variation in Pourcelot's index
(PI, the ratio of maximum systolic-end diastolic difference to the systolic
velocity) was noted between the internal carotid and the pericallosal
arteries: 0.88 +/- 0.01 vs. 0.76 +/- 0.02, (P less than 0.05). A nearly
parabolic velocity profile was documented in the vessels studied.
