Extracorporeal membrane oxygenation in infants: Angiographic and parenchymal evaluation of the brain with MR imaging

The authors report their preliminary experience with intracranial three-dimensional Fourier transform magnetic resonance (MR) angiography and T2-weighted MR imaging of the brain parenchyma in 15 neonates less than 1 week old after extracorporeal membrane oxygenation (ECMO) with permanent ligation of the right common carotid artery and internal jugular vein, four 1-year-old infants after ECMO with carotid ligation, and four neonates less than 1 week old after ECMO with reanastomosis of the same artery. MR angiography was technically satisfactory in 20 of the 23 patients and documented patency of the right internal carotid artery proximal to the ophthalmic artery in nine of 16 patients with permanent carotid ligation and in all four patients with reanastomosis. This study suggests MR angiography is feasible in newborns and infants and that, in combination with parenchymal MR imaging, it provides a sensitive, noninvasive method to assess vessel patency and follow cerebrovascular and parenchymal changes in infants after ECMO.