Brain perfusion in children: Evolution with age assessed by quantitative perfusion computed tomography

Objective. The objective of this study was to assess the age-related variations of brain perfusion through quantitative cerebral perfusion computed tomography (CT) results in children without brain abnormality. Methods. Brain perfusion CT examinations were performed in 77 children, aged 7 days to 18 years. These patients were admitted at our institution for both non-contrast and contrast-enhanced cerebral CT. Only children whose conventional cerebral CT and clinical/radiologic follow-up, including additional investigations, were normal were taken into account for this study (53 of 77). Results. The average regional rCBF amounts to 40 (mL/100 g per minute) for the first 6 months of life, peaks at ∼130 (mL/100 g per minute) at ∼2 to 4 years of age, and finally stabilizes at ∼50 (mL/100 g per minute) at ∼7 to 8 years of age, with a small increase of rCBF values at ∼12 years of age. The rCBF in the gray matter averages 3 times that in the white matter, except for the first 6 months of life. The global CBF represents 10% to 20% of the global cardiac output for the first 6 months of life, peaks at ∼55% by 2 to 4 years of age, and finally stabilizes at ∼15% by 7 to 8 years of age. Specific age-related evolution patterns were identified in the different anatomic areas of the cerebral parenchyma, which could be related to the development of neuroanatomic structures and to the emergence of corresponding cognitive functions. Conclusions. Quantitative perfusion CT characterization of brain perfusion shows specific age variations. Brain perfusion of each cortical area evolves according to a specific time course, in close correlation with the psychomotor development.