T2-prepared velocity selective labelling: A novel idea for full-brain mapping of oxygen saturation

Abstract

Background and aim: Disturbances in cerebral oxygenation saturation (SO₂) have been linked to adverse outcome in adults, children, and neonates. In intensive care, the cerebral SO₂ is increasingly being monitored by Near-InfraRed Spectroscopy (NIRS). Unfortunately NIRS has a limited penetration depth. The "modified T₂-prepared Blood Imaging of Oxygen Saturation" (T₂-BIOS) MR sequence provides a step towards full brain SO₂ measurement.

Materials and methods: Tissue SO₂, and venous SO₂ (S_vO₂) were obtained simultaneously by T₂-BIOS during a respiratory challenge in ten healthy volunteers. These two measures were compared to SO₂ that was obtained by a single probe MR-compatible NIRS setup, and to cerebral blood flow and venous SO₂ that were obtained by arterial spin labelling and T₂-TRIR, respectively.

Results: SO_2-T2-BIOS and SO_2-NIRS had a mean bias of -4.0% (95% CI -21.3% to 13.3%). S_vO_2-T2-BIOS correlated with SO_2-NIRS (R²=0.41, p=0.002) and S_vO_2-T2-TRIR (R²=0.87, p=0.002). In addition, SO_2-NIRS correlated with S_vO_2-T2-TRIR (R²=0.85, p=0.003) Frontal cerebral blood flow correlated with SO_2-T2-BIOS (R²=0.21, p=0.04), but was not significant in relation to SO_2-NIRS.

Discussion/conclusion: Full brain SO₂ assessment by any technique may help validating NIRS and may prove useful in guiding the clinical management of patient populations with cerebral injury following hypoxic-ischaemic events. The agreement between NIRS and T₂-BIOS provides confidence in measuring cerebral SO₂ by either technique. As it stands now, the T₂-BIOS represents a novel idea and future work will focus on improvements to make it a reliable tool for SO₂ assessment.

Keywords: Adults; Cerebral oxygenation; Near-Infrared Spectroscopy; Respiratory challenge.