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Longitudinal Change of Cerebral Blood Flow Velocity in Neonates with the Doppler Technique

Journal of the Korean Pediatric Society 1992;35(1):60-68.
Published online January 15, 1992.
Longitudinal Change of Cerebral Blood Flow Velocity in Neonates with the Doppler Technique
Kook In Park1, Dong Gwan Han1, Ran Namgung1, Chul Lee1, Jin Suk Suh2, Myung Joon Kim2
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
2Department of Diagnostic Radiology, College of Medicine, Yonsei University, Seoul, Korea
도플러를 이용한 신생아 뇌혈류속도의 종적변동에 관한 연구
박국인1, 한동관1, 남궁란1, 이철1, 서진석2, 김명준2
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 진단방사선과
Abstract
Eighty-one asymptomatic preterm, term-SGA, and full term infants who were delivered at Yonsei University Severance Hospital from January to July 1990 were studied with color duplex imaging doppler sonography to assess the postnatal changes of the cerebral blood flow velocity longitudinally. Pulsatility index (PI) and area under the velocity curve (AUVC) were calculated to quantitate changes in anterior cerbral artery blood flow velocity evaluated via the anterior fontanelle. The results were obtained as follows; 1) In 62 asymptomatic preterm and term infants who were supine, Pis were initally raised, falling over the first day of life and remaining stable thereafter. AUVCs were initally lowered, raising over the first day of life and remaining stable thereafter. 2) Decreases in PI were principally due to a increase in diastolic velocity, with relatively little change occurring in systolic velocity. 3) The mode of delivery did not significantly affect the changes of PI & AUVC in 40 normal full term infants. 4) There was no significant change in heart rate as a function of age, but the mean systemic blood pressure did rise from 44.2mmHg on day 1 to 47.2 mmHg on day 2 and remained stable thereafter in normal full term infants. 5) Preterm infants showed higher Pis at second day of life and lower AUVCs at second and third day of life than those of term infants. This means that the cerebral blood flow velocity in preterms become normalized later than mature neonates. 6) Cerebral blood flow velocities were seen to increase with increasing gestational age and with increasing age of the neonate. But Pis decreased progressively with increasing gestational age. 7) In 19 asymptomatic term-SGA infants, Pis were not changed during 7 days after birth. But AUVCs were initially lowered, raising over the first day of life. No signigicant differences were found for the PI & AUVC between term-SGA and normal term infants.
Key Words: Pulsatility index(PI), Area under the velocity curve(AUVC), Cerebral blood flow velocity, Doppler sonography, Newborn


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