Lynette Looi Ling¹, Amanda Wood¹, Elaine Foley¹, and Stefano Seri ^1,2
1School of Life and Health Sciences & Aston Neuroscience Institute, Aston University, Birmingham, West Midlands, United Kingdom, ²Children’s Epilepsy Surgery Service, Birmingham Children’s and Women’s Hospital NHS Foundation Trust, Birmingham, United Kingdom

Epilepsy is a common neurological disorder diagnosed in children that can be associated with impairments in sustained attention. Attentional deficits are linked to neural dysfunction within or between the default mode network and central executive network. Limited research has examined abnormalities in these networks in children with epilepsy. Using resting-state fMRI we found reduced connectivity within and between both networks in patients (n=18) compared to controls (n=16). The neural alterations found in patients could be potential predictors of attentional deficits, and subsequently aid in identifying children requiring intervention, however further studies are warranted to confirm this.  

Min-Hee Lee^1,2, Nolan O'Hara^2,3, Csaba Juhasz^1,2,3,4, Eishi Asano^1,3,4, and Jeong-Won Jeong^1,2,3,4
1Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States, ²Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, MI, United States, ³Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, United States, ⁴Neurology, Wayne State University School of Medicine, Detroit, MI, United States

To investigate the clinical utility of deep convolutional neural network (DCNN)-tract-classification in the preoperative evaluation of children with focal epilepsy, DCNN-tract-classification deeply learned spatial trajectories of DWI tracts linking electrical stimulation mapping (ESM) findings, and then used to detect eloquent tracts. We found that the DCNN-tract-classification can achieve an excellent accuracy (98%) to detect eloquent areas. Also, the subsequent Kalman filter analysis showed that the preservation of detected areas predicts no postoperative deficits with a high mean accuracy across different functions (92%). Our findings demonstrate that DCNN-tract-classification may offer vital translational information in pediatric epilepsy surgery. 

Serafeim Loukas^1,2, Sandra Martin¹, Joana Sa de Almeida¹, Lana Vasung^1,3, Dimitri Van De Ville², Djalel Meskaldji^1,4, and Petra S. Hüppi^1
1Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland, ²Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland, ³Division of Newborn Medicine, Department of Medicine, Harvard Medical School, Boston, MA, United States, ⁴Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland

During early brain development, rs-functional connectivity exhibits regional and age-specific activation patterns. We hypothesize that these rs-fMRI patterns might reflect maturity of intracerebral microvascular compartment linked to spatio-temporal genetic expression patterns. The genetic patterns were explored through postmortem human brain specimens and the rs-fMRI connectivity using a longitudinal preterm dataset. rs-functional connectivity and angiogenic genes expression show spatio-temporal differences during early brain development. We observe an increased role of the primary somatosensory and motor cortices from late-fetal to neonatal periods that might be driven by an increased expression of important angiogenic genes in these regions.

Yu-Chen Chuang¹, Hsiao-Lan Sharon Wang², and Jun-Cheng Weng^1,3,4
1Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, ²Department of Special Education, National Taiwan Normal University, Taipei, Taiwan, ³Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan, ⁴Medical Imaging Research Center, Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

Reading disability is a special learning disorder based on the neurophysiological of the brain. Schooling children with reading disabilities (CRD) have different ways to process language from normal children (NCRD). Our study investigated the abnormality of brain volume and shape contributing to specific reading disabilities in schooling children. We found the significant difference in brain volume and shape of the parietal, temporal lobe and limbic system between CRD and NCRD. These brain areas are associated with the core phonological processing regions.

Jianhong Li¹, Weiwei Men², David Zhu³, and Junfang Xian^1
1Radiology, Beijing Tongren Hospital,Capital Medical University, Beijing, China, ²Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China, ³Radiology and Cognitive Imaging Research Center, Michigan State University, East Lansing, MI, United States

Early profound deaf children and adolescents have been reported to suffer from cognitive decline and attentional deficit. Twenty-five inattentive children and adolescents with bilateral prelingual profound deafness and 30 age- and gender- matched normal controls were recruited in this study. The resting state functional connectivity differences were analyzed between two groups. The results indicated a direct impact of early auditory deprivation on high cognitive networks. The usage of hearing aid was also found to normalize the connectivity between primary auditory cortex and attention network.

Shiva Shahrampour¹, Benjamin De Leener², Devon Middleton¹, Mahdi Alizadeh¹, Laura Krisa¹, Adam Flanders³, Scott Faro³, Julien Cohen-Adad², and Feroze Mohamed^1
1Thomas Jefferson University, Philadelphia, PA, United States, ²Polytechnique Montreal, Montreal, QC, Canada, ³Thomas Jefferson University Hospital, Philadelphia, PA, United States

Spinal cord diffusion tensor imaging and atlas-based group analysis has potential for improving prognosis of spinal cord related diseases, aid clinical decision making and provide quantitative imaging biomarkers for spinal cord injury assessment.

Douglas C Dean^1,2,3, Jason F Moody², Steve R Kecskemeti³, Nakul Aggarwal⁴, Jonathan A Oler⁴, Andrew L Alexander^2,3,4, and Ned Kalin^4
1Pediatrics, University of Wisconsin–Madison, Madison, WI, United States, ²Medical Physics, University of Wisconsin–Madison, Madison, WI, United States, ³Waisman Center, University of Wisconsin–Madison, Madison, WI, United States, ⁴Psychiatry, University of Wisconsin–Madison, Madison, WI, United States

Quantitative relaxometry affords a unique opportunity to map dynamic patterns of white matter development. Nonhuman primates offer a valuable model for investigating neurodevelopment, however, NHP studies utilizing relaxometry based approaches have been limited. Here, we utilize R₁ relaxometry to map maturation in 35 rhesus macaques scanned across 5 timepoints during the first year of life. R₁ is observed to rapidly increase during this period, with average and individual patterns exhibiting a logarithmic-like trajectory. Results highlight the onset of myelin during this period of development and demonstrate relaxometry to be a promising approach for characterizing patterns of early brain development. 

Lijia Zhang¹, Chris Petty¹, and Allen Song^1
1Duke University Brain Imaging and Analysis Center, Durham, NC, United States

Quantitative susceptibility mapping (QSM) has the potential to help access brain development, in particular, the magnetic susceptibility changes during the myelination processes in the white matter. However, the quantitative accuracy of QSM is limited by its angle dependency to the fiber orientation. In this study, we propose a method utilizing ultra-high resolution diffusion tensor imaging (DTI) to delineate the major fiber bundles (i.e. corpus callosal fibers), followed by tract-based QSM, to largely remove the angle dependence and accurately quantify the magnetic susceptibility changes during brain development.

Tingting Huang^1,2, Zhe Liu¹, Chao Jin¹, Haoxiang Jiang³, Heng Liu¹, Wei Xing², Xiaocheng Wei⁴, Gang Zhang², and Jian Yang^5
1The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China, ²The First Affiliated Hospital of Henan University of traditional Chinese Medicine, Zhengzhou, China, ³Xi’an Children Hospital, Xi’an, China, ⁴GE Healthcare, Peking, China, ⁵The First Affiliated Hospital of Xi’an Jiaotong University, Zhengzhou, China

Early identification of classification of cerebral palsy (CP) in children with periventricular leukomalacia (PVL) is crucial for specific  rehabilitation treatment and improving the quality of life. In this study, we retrospectively analyzed the baseline clinical data and visually assessed PVL-associated MR signs in children with CP, found that T2WI abnormal hyperintensity in body of lateral ventricle, posterior limb of internal capsule (PLIC), lenticular nucleus and white matter volume reduction were independent predictors of spastic CP. Results indicated that the area under receiver operating characteristic curve of multivariate regression model was 0.85, sensitivity and specificity for this model were 74.4% and 85.7%, respectively.

Xianjun Li¹, Yuli Zhang¹, Mengxuan Li¹, Miaomiao Wang¹, Congcong Liu¹, Chao Jin¹, Xiaocheng Wei¹, and Jian Yang^1
1Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China

Human brain exhibits structural and functional asymmetries. How the left-lateralization in white matter changes with age from newborns through childhood is not fully investigated. In this work, development of the left-lateralization from birth to 13 years is revealed by using tract-based spatial statistics with dynamic age-specific brain templates. Structural left-lateralization with larger fractional anisotropy in motor-related and language-related white matter is already present in newborns. The involvement of corticospinal tract, superior longitudinal fasciculus and uncinate fasciculus into regions with left-lateralization appears at different age. This may be associated with the development of fine motor and language during the early childhood.

Xiaoyu Wang¹, Cong Tian¹, Xinxin Tao¹, Mengxuan Li¹, Yuli Zhang¹, Xiaocheng Wei², and Jian Yang^3
1The first affliated hospital of Xi'an Jiaotong University, Xi'an, China, ²MR Research China, GE Healthcare, Beijing, China, ³Radiology, The first affliated hospital of Xi'an Jiaotong University, Xi'an, China

Septo-optic dysplasia (SOD) is a rare congenital malformation disorder and have equally prevalent in males and females in early brain development. This study evaluated the micro-structure of optic radiation pathway using automatic fiber bundle quantization tracking (AFQ)in DT image to investigate the possible developmental impairment of optic radiation pathway that might cause by the abnormalanatomy structure of SOD patient.  Result showed abnormal changes of optic radiation were found in SOD patients.  The DTI tractography result could provides a non-invasive mapping of the optic radiation pathway and locate the injury.

Ruohan Feng¹, Lihua Zhuo¹, Xinyue Hu², Yingxue Gao², Lianqing Zhang², Yang Li³, Xinyu Hu², Shi Tang², Ming Zhou¹, Guoping Huang³, and Xiaoqi Huang^2
1Department of Radiology, the third hospital of Mianyang, Mianyang, China, Mianyang, China, ²Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China, Chengdu, China, ³Department of Psychiatry, the third hospital of Mianyang, Mianyang, China, Mianyang, China

We analysis  subcortical nucleus volume in 57 adolescents aged 13-18: 35 with MDD and 22 healthy controls (HC). Compared to HCs, the MDD group showed reduction in volume of the HATA nuclei of the left hippocampus and the subiculum nuclei of the right hippocampus, and increased volume in the LD、MDI、 MDm of the left thalamus and in the MV(Re) of the right thalamus. There were no significant difference in amygdala subregion between the MDD group and the HC group. We propose that  these subregions will contribute to the affective and cognitive abnormities in adolescents with MDD.

Nivedita K. Naresh¹, Doaa Aly², Michal Schafer², Brian Fonseca³, Bruce Landeck², Jenna Sopfe⁴, Lorna P Browne¹, and Alex J Barker^1,5
1Radiology, Children's Hospital Colorado, Aurora, CO, United States, ²Cardiology, Children's Hospital Colorado, Aurora, CO, United States, ³Pediatrics, Children's Hospital Colorado, Aurora, CO, United States, ⁴Oncology, Children's Hospital Colorado, Aurora, CO, United States, ⁵Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, United States

In this retrospective study, we explored the potential of cardiac MRI to identify functional imaging biomarkers of cardiotoxicity in pediatric patients exposed to anthracycline chemotherapy. Global and regional myocardial strain was reduced in patients with ejection fraction (EF)>50% indicating that myocardial strain may be an early imaging biomarker of cardiotoxicity in pediatric patients. Additionally, regional differences were found in strain measurements in this population. The results from this study will be used to perform prospective imaging studies to identify early functional imaging biomarkers of cardiotoxicity in pediatric population.  

Yuli Zhang¹, Xianjun Li¹, Mengxuan Li¹, Qinli Sun¹, Miaomiao Wang¹, Chao Jin¹, Congcong Liu¹, Fan Wu¹, Xiaoyu Wang¹, Huifang Zhao¹, Yannan Chen¹, Cong Tian¹, Peiyao Chen¹, Xiaocheng Wei², and Jian Yang^1
1the First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China, ²2. MR Research China, GE Healthcare, Xi'an, China, China

Brain development is a complex process linked with behavioral, emotional, cognitive, especially the maturation process of WM is both of great scientific and clinical importance¹. However, the lack of continuous development of WM from neonate to childhood. Diffusion kurtosis imaging(DKI)is a diffuse imaging method that reflects non-Gaussian distribution information of biological water. This study aimed to use DKI parameters depicting developmental trajectory of WM. The fractional anisotropy(FA), mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK)positively correlated with age; the axial diffusivity(AD) radial diffusivity(RD) negativly correlated with age. These parameters changed rapidly before the age of 2 years old, and then gradually slowed down.

Melanie Ehrler¹, Michael von Rhein^1,2, Oliver Kretschmar³, Beatrice Latal¹, and Ruth O'Gorman Tuura^4
1Child Development Center, University Children's Hospital, Zurich, Switzerland, ²Developmental Pediatrics, Cantonal Hospital Winterthur, Winterthur, Switzerland, ³Cardiology, University Children's Hospital, Zurich, Switzerland, ⁴Center for MR Research, University Children's Hospital, Zurich, Switzerland

Children with congenital heart diseases (CHD) undergoing open-heart surgery are at an increased risk of motor impairment, but little is known about the neuroanatomical correlates of these deficits. The purpose of the present study was to examine the link between corticospinal tract (CST) microstructure, assessed with diffusion tensor MRI, and motor function in a cohort of adolescents with operated CHD. Compared to age-matched controls, adolescents with CHD showed lower CST anisotropy which correlated with worse fine motor function and poorer movement quality. CHD may therefore lead to alterations in motor tract development, increasing the risk of persistent motor impairments.

Liwei Hu¹, Xiaodan Zhao², Rongzhen Ouyang¹, Shuang Leng², WeiHui Xie¹, Yafeng Peng¹, Xiaofen Yao¹, Yong Zhang³, Ru San Tan^2,4, Liang Zhong^2,4, and Yumin Zhong^1
1Radiology, Shanghai Children's Medical Center, Shanghai, China, ²National Heart Centre Singapore, Singapore, Singapore, ³GE Healthcare, Shanghai, China, ⁴Duke-NUS Medical School, National University of Singapore, Singapore, Singapore

Right ventricular (RV) and atrial (RA) dilation has been clinically observed in patients after initial repair of tetralogy of Fallot (rTOF) and is associated with adverse long-term outcomes. Due to RA and left atrial (LA) interaction, we aimed to determine the effect of RA dilation on LA performance from feature tracking cardiovascular magnetic resonance (CMR) in pediatric rTOF patients. Results revealed that LA strains and strain rates were impaired in rTOF than age- and gender-matched healthy volunteers. RA volumes are negatively associated with LA strains. These findings may suggest LA diastolic dysfunction from chronic RV and RA dilations in rTOF, even at early stage after initial repair.

Lexiaozi Fan^1,2, Hassan Haji-Valizadeh³, Cynthia K Rigsby⁴, Joshua D. Robinson⁴, Paige Constance Nelson⁴, and Daniel Kim^1,2
1Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ²Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States, ³Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, United States, ⁴Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Cardiovascular MRI is an excellent diagnostic tool for children with congenital heart disease (CHD), but the long acquisition times, and need for sedation/anesthesia and the administration of a gadolinium-based contrast results it only accounts for only 2% of pediatric cardiac diagnostic tests. Our 20-min, free-breathing, non-contrast cardiovascular magnetic resonance (CMR) protocol is potentially a game-changer, because its total scan time (20 min) is considerably shorter than a standard protocol (90 min) and does not require anesthesia or gadolinium-based contrast agent.

Kristina Zvolanek^1,2, Rachael Stickland¹, and Molly Bright^1,2
1Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States, ²Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States

Cerebrovascular reactivity (CVR) mapping with MRI is emerging as a useful metric of vascular health. Tracking natural fluctuations in CO₂ (a vasodilator) during a resting state fMRI scan has been proposed as a method to map CVR, but it is uncertain whether this method is reliable. We propose adding a two-minute breathing challenge prior to a resting state acquisition to transiently reduce CO₂ levels. Here, we tested the feasibility of this method in a small pediatric cohort. The breathing challenge produced more robust CVR maps in both controls and children with cerebral palsy compared to resting state data alone.

Zungho Zun^1,2,3,4, Kushal Kapse¹, Marni Jacobs^3,5, Sudeepta Basu^3,6, Mariam Said^3,6, Nicole Andersen¹, Jonathan Murnick^1,3,4, Taeun Chang^3,7,8, Adre du Plessis^2,3, and Catherine Limperopoulos^1,2,3,4
1Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, United States, ²Division of Fetal and Transitional Medicine, Children’s National Hospital, Washington, DC, United States, ³Department of Pediatrics, George Washington University, Washington, DC, United States, ⁴Department of Radiology, George Washington University, Washington, DC, United States, ⁵Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, United States, ⁶Division of Neonatology, Children's National Hospital, Washington, DC, United States, ⁷Division of Neurology, Children's National Hospital, Washington, DC, United States, ⁸Department of Neurology, George Washington University, Washington, DC, United States

Early newborn age is a crucial phase of brain development, which can be characterized by in-vivo measurement of cerebral blood flow (CBF). In this study we assessed regional CBF in very preterm infants longitudinally during the ex-utero third trimester using arterial spin labeling. CBF in preterm infants significantly increased with postmenstrual age in all regions with the most rapid increase and the highest mean of CBF in the cerebellum. Lower CBF was associated with intraventricular hemorrhage and patent ductus arteriosus. CBF in preterm infants was higher than that of healthy full-term controls at term equivalent age. 
 

Xiaofen Yao¹, Liwei Hu¹, Rongzhen Ouyang¹, Yafeng Peng¹, Weihui Xie¹, Fei Feng², and Yumin Zhong^1
1Shanghai Children's Medical Center, Shanghai, China, ²GE Healthcare, Shanghai, China

4D flow CMR has been used to assess right and left ventricular function with increasing attention. We hypothesis that the results of right and left ventricular volume quantification using 4D flow has the same accuracy compared to that with 2D b-SSFP cine sequence in children with repaired Tetralogy of Fallot (r-TOF).

Rongzhen Ouyang¹, Shuang Leng², Liwei Hu¹, Aimin Sun¹, Qian Wang¹, Xiaofen Yao¹, Xiaodan Zhao², Ru-San Tan², Yong Zhang³, Liang Zhong^2,4, and Yumin Zhong^1
1Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China, ²National Heart Centre Singapore, Singapore, Singapore, ³GE Healthcare, Shanghai, China, ⁴Duke-NUS Medical School, National University of Singapore, Singapore, Singapore

Right ventricular (RV) ejection fraction (EF) <45% is insensitive for detecting systolic dysfunction due to pulmonary regurgitation after Tetralogy of Fallot repair (rTOF). In pediatric rTOF patients with RVEF≥45% and healthy controls, CMR feature tracking was used to assess RV systolic strains and displacement as well as systolic and diastolic myocardial velocities. We observed abnormal RV global longitudinal strain and myocardial velocities in rTOF despite normal RVEF. 78% and 75% of rTOF patients had tricuspid annular displacement systolic excursion <10.9 mm and peak systolic myocardial velocity <6.3cm/s (lower normal limits among controls), respectively, indicating high prevalence of systolic functional impairment.  

Dengrong Jiang¹, W. Christopher Golden², Charlamaine Parkinson², Li Pan³, Zixuan Lin¹, Hanzhang Lu¹, Aylin Tekes¹, Frances Northington², and Peiying Liu^1
1Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States, ³Siemens Healthineers, Baltimore, MD, United States

Hypoxic-ischemic-encephalopathy (HIE) is a leading cause of neonatal mortality and severe neurological impairment in childhood. Quantification of cerebral oxygen utilization in HIE neonates may provide valuable information to guide the treatment and predict clinical outcomes. Oxygen-extraction-fraction (OEF) is an important index of the brain’s oxygen utilization. In this work, we used a rapid, non-invasive MRI technique to measure the global OEF in HIE neonates, and examined the association of OEF with Apgar scores and the severity of HIE. We demonstrated that global OEF was associated with 10minute Apgar score. Global OEF also decreased with the severity of HIE.

Rajesh Kumar^1,2,3,4, Bhaswati Roy¹, Xingfeng Shao⁵, Nancy J. Halnon⁶, Alan B. Lewis⁷, Mary A. Woo⁸, Danny JJ Wang^5,9, and Nancy A. Pike^8
1Anesthesiology, University of California at Los Angeles, Los Angeles, CA, United States, ²Radiology, University of California at Los Angeles, Los Angeles, CA, United States, ³Bioengineering, University of California at Los Angeles, Los Angeles, CA, United States, ⁴Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, United States, ⁵Neurology, University of Southern California, Los Angeles, CA, United States, ⁶Division of Pediatric Cardiology, University of California at Los Angeles, Los Angeles, CA, United States, ⁷Division of Pediatric Cardiology, Children's Hospital of Los Angeles, Los Angeles, CA, United States, ⁸UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA, United States, ⁹Radiology, University of Southern California, Los Angeles, CA, United States

Single ventricle heart disease (SVHD) presents with either a dominant single right ventricle (RV) or left ventricle (LV). Individuals with RV dominant SVHD show worse outcomes, including worse cognition and quality of life, which may result from decreased cardiac output due to differences in ventricular size, shape, and function or other structural related sequela, contributing to regional cerebral blood flow (CBF) changes. We examined CBF changes between RV and LV over controls, and found more wide-spread changes in RV over LV. These findings indicate that worse outcomes in RV SVHD may result from compromised CBF over LV SVHD.

Nicolas Aristokleous¹, Petter Frieberg¹, Johannes Töger ¹, Petru Liuba², Pia Sjöberg¹, Einar Heiberg ¹, and Marcus Carlsson^1
1Department of Clinical Sciences Lund, Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden, ²Department of Clinical Sciences Lund, Pediatric Heart Center, Skåne University Hospital, Lund University, Lund, Sweden

Computational fluid dynamics (CFD) modelling may help patients with heart defects by predicting blood flow after interventions thus aiding surgical planning. Current CFD-techniques are not clinically feasible due to long computational times. We compared a simplified CFD technique to the state-of-the-art advanced CFD and validated the results with Magnetic Resonance Imaging. We could show that the simplified CFD method on a conventional laptop saved between 75%-99% computing time compared with advanced CFD on a dedicated computation server with comparable accuracy in results of flow distributions. This simplified CFD method may facilitate the implementation of CFD predictions in a clinical setting.

Lajja Desai^1,2, Juliet Varghese³, Rizwan Ahmad³, Orlando Simonetti³, Cynthia Rigsby², and Michael Markl^1
1Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ²Lurie Children's Hospital of Chicago, Chicago, IL, United States, ³Ohio State University, Columbus, OH, United States

Cardiac magnetic resonance (CMR) can be utilized for non-invasive estimation of blood oxygen (O2) saturation in complex pediatric heart disease (i.e., single ventricle physiology) with good correlation to current gold standard catheter-derived measurements. Oximetry maps derived from T2 CMR data can enhance visualization of regional O2 saturations and may guide optimization of image acquisition and analysis.

Pei-Hsin Wu¹, Alexandra Batzdorf¹, Arastoo Vossough², Daniel J. Licht², Mark A. Fogel², and Felix W. Wehrli^1
1Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ²The Children's Hospital of Philadelphia, Philadelphia, PA, United States

CMRO₂ was evaluated by MR susceptometry. The hypothesis that CMRO₂ is lower in sedated young children with single ventricle heart defects (SVD) was investigated in this study. The results show that (1) lower CMRO₂ was found in young subjects after administration of sevoflurane, compared to their unsedated peers, (2) brain volumes in patients with SVD were comparable to those reported in healthy children, (3) cerebral blood flow was smaller than the values reported in healthy subjects. The preliminary data indicate that results from awake and sedated subgroups cannot be pooled, at least not for the study of the neurometabolic consequences.

Qiang Zheng¹, Chenying Zhao², Minhui Ouyang³, Arastoo Vossough⁴, Giulio Zuccoli³, Raymond Wang Sze⁴, Hao Huang⁴, and Misun Hwang^4
1School of Computer and Control Engineering, Yantai University, Yantai, China, ²University of Pennsylvania, Philadelphia, PA, United States, ³Children’s Hospital of Philadelphia, Philadelphia, PA, United States, ⁴Children’s Hospital of Philadelphia; University of Pennsylvania, Philadelphia, PA, United States

Diffusion tensor imaging (DTI) plays an important role in the diagnosis and prognosis of neonatal hypoxic ischemic encephalopathy (HIE). However, studies on DTI in HIE neonates with normal DWI, T1/T2-weighted images (referred as conventional MRI) are rarely reported. Here, we compared fractional anisotropy (FA), mean diffusivity, radial diffusivity, axial diffusivity among controls, HIE neonates with normal conventional MRI, and HIE neonates with abnormal conventional MRI. The results demonstrate that FA is the most sensitive DTI measurement, and significantly decreased in HIE neonates with normal MRI, suggesting the importance of inclusion of DTI for evaluating HIE in clinical practice and research.

Miaomiao Wang¹, Xianjun Li¹, Yuli Zhang¹, Fan Wu¹, Congcong Liu¹, Xiaoyu Wang¹, Cong Tian¹, Peiyao Cheng¹, Mengxuan Li¹, Chao Jin¹, XiaoCheng Wei², and Jian Yang^1
1The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China, ²MR Research China, GE Healthcare, Beijing, China

White matter injury is common in neonates. The most common punctate white matter lesions (PWML) can disappear along with time and are easily missed diagnosis. Most current clinical scores account for the numbers and the size of PWML, but ignore the lesion location, which is important for the outcome prediction. This study aims to quantitatively assess the distribution of mild PWML in preterm and term neonates, and characterize its dynamic alterations with gestational age. Our study found that mild PWML is mainly located in the posterior of brain, with extensive injury in the preterm extending to the central region.

Vincent Jerome Schmithorst¹, Jodie Votava-Smith², and Ashok Panigrahy^1
1Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States, ²Children's Hospital of Los Angeles, Los Angeles, CA, United States

Functional network topology was compared between neonates with congenital heart disease (CHD) and normal controls and sex-X-CHD interactions were investigated.  Using a cost-independent analysis, CHD neonates displayed reduced segregation globally (modularity, transitivity) and nodally (clustering coefficient, participation coefficient) mainly in frontal and subcortical regions; no significant sex-X-CHD interactions were found.  Using a cost-dependent analysis, CHD neonates displayed reduced integration and segregation globally (global efficiency, transitivity) and nodally (nodal efficiency, clustering coefficient) in frontal, temporal, and subcortical regions.  Significant sex-X-CHD interactions (M>F) were found in similar regions.  Results may support a neurophysiological basis for differential neurodevelopmental outcomes related to sex.