Fraction of Inspired Oxygen in Relation to Cerebrospinal Fluid Hyperintensity on FLAIR MR Imaging of the Brain in Children and Young Adults Undergoing Anesthesia
Chantal Frigon1,
David S. Jardine2,
Ed Weinberger3,
Susan R. Heckbert1 and
Dennis W. W. Shaw3
1 Department of Anesthesiology, Box 359300, University of Washington, Seattle,
WA 98195.
2 Department of Epidemiology, Box 357236, University of Washington, Seattle, WA
98195.
3 Department of Radiology, CH-69, Children's Hospital and Regional Medical
Center, 4800 Sand Point Way N. E., Seattle, WA 98105.
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Fig. 1A. —Fluid-attenuated inversion recovery (FLAIR) MR images in
5-year-old boy undergoing anesthesia with halothane who received supplemental
oxygen during two separate MR imaging examinations. FLAIR images obtained at
level of basilar cisterns (A) and cerebral sulci (B) while
patient was receiving inspired oxygen fraction of 1.0 show hyperintensity of
cerebrospinal fluid (CSF) compared with brain (grade 2).
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Fig. 1B. —Fluid-attenuated inversion recovery (FLAIR) MR images in
5-year-old boy undergoing anesthesia with halothane who received supplemental
oxygen during two separate MR imaging examinations. FLAIR images obtained at
level of basilar cisterns (A) and cerebral sulci (B) while
patient was receiving inspired oxygen fraction of 1.0 show hyperintensity of
cerebrospinal fluid (CSF) compared with brain (grade 2).
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Fig. 1C. —Fluid-attenuated inversion recovery (FLAIR) MR images in
5-year-old boy undergoing anesthesia with halothane who received supplemental
oxygen during two separate MR imaging examinations. FLAIR images obtained at
same levels as A and B during subsequent MR imaging examination
when inspired oxygen fraction was 0.5. CSF is dark (grade 0). (Because only
first examination for any patient was entered into this study, images C
and D were excluded from analysis.)
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Fig. 1D. —Fluid-attenuated inversion recovery (FLAIR) MR images in
5-year-old boy undergoing anesthesia with halothane who received supplemental
oxygen during two separate MR imaging examinations. FLAIR images obtained at
same levels as A and B during subsequent MR imaging examination
when inspired oxygen fraction was 0.5. CSF is dark (grade 0). (Because only
first examination for any patient was entered into this study, images C
and D were excluded from analysis.)
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Fig. 2. —Bar graph shows distribution of inspired oxygen fraction
levels among 70 patients.
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Copyright © 2002 by the American Roentgen Ray Society.
= none [0], [UNK] = mild [1], 
= marked [2]) among 70 patients.
Bar graphs show patients who received low (
0.6) and high (>0.6)
inspired oxygen fraction in basilar cisterns (A) and sulcar
subarachnoid space (B). Most subjects in low inspired oxygen fraction
group had no hyperintensity in basilar cisterns (A); however, in sulcal
subarachnoid space (B) many had sufficient oxygen pressure to show
hyperintensity even with this lesser degree of supplementation. In both
regions, total percentage of mild and marked hyperintensity increased in
patients with higher level of oxygen supplementation. (Basilar cisterns,
p < 0.001; sulcal subarachnoid space, p = 0.03.)