Impact of neonate haematocrit variability on the longitudinal relaxation time of blood: Implications for arterial spin labelling MRI

Abstract

Background and purpose: The longitudinal relaxation time of blood (T1b) is influenced by haematocrit (Hct) which is known to vary in neonates. The purpose of this study was threefold: to obtain T1b values in neonates, to investigate how the T1b influences quantitative arterial spin labelling (ASL), and to evaluate if known relationships between T1b and haematocrit (Hct) hold true when Hct is measured by means of a point-of-care device. Materials and methods: One hundred and four neonates with 120 MR scan sessions (3 T) were included. The T1b was obtained from a T1 inversion recovery sequence. T1b-induced changes in ASL cerebral blood flow estimates were evaluated. The Hct was obtained by means of a point-of-care device. Linear regression analysis was used to investigate the relation between Hct and MRI-derived R1 of blood (the inverse of the T1b). Results: Mean T1b was 1.85 s (sd 0.2 s). The mean T1b in preterm neonates was 1.77 s, 1.89 s in preterm neonates scanned at term-equivalent age (TEA) and 1.81 s in diseased neonates. The T1b in the TEA was significantly different from the T1b in the preterm (p < 0.05). The change in perfusion induced by the T1b was −11% (sd 9.1%, p < 0.001). The relation between arterial-drawn Hct and R1b was R1b = 0.80 × Hct + 0.22, which falls within the confidence interval of the previously established relationships, whereas capillary-drawn Hct did not correlate with R1b. Conclusion: We demonstrated a wide variability of the T1b in neonates and the implications it could have in methods relying on the actual T1b as for instance ASL. It was concluded that arterial-drawn Hct values obtained from a point-of-care device can be used to infer the T1b whereas our data did not support the use of capillary-drawn Hct for T1b correction.

Keywords

• Blood T1
• Neonates
• Arterial spin labelling
• Cerebral blood flow
• Haematocrit
• MRI