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However, the effect of preterm birth on cerebral oxygen metabolism and its underlying mechanism have not been fully elucidated. The present study measured cerebral oxygen extraction and metabolism using noncontrast magnetic resonance imaging (MRI) methods in preterm neonates and examined its relationship with anemia of prematurity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty neonates with a gestational age of 28\u201342 weeks were enrolled. Cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO<jats:sub>2<\/jats:sub>) were measured with T<jats:sub>2<\/jats:sub>\u2010relaxation\u2010under\u2010spin\u2010tagging (TRUST) MRI, together with cerebral blood flow (CBF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We showed that CBF (<jats:italic>p<\/jats:italic>\u2009=\u20090.00021) and CMRO<jats:sub>2<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) increased with gestational age while OEF increased with postnatal age (<jats:italic>p<\/jats:italic>\u2009=\u20090.0013). Higher OEF was also associated with a higher Apgar score at birth (<jats:italic>p<\/jats:italic>\u2009=\u20090.039). Furthermore, hematocrit\u00a0significantly mediates the increase of OEF with postnatal age (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Structural equation modeling analysis suggested a bidirectional relationship between CBF and CMRO<jats:sub>2<\/jats:sub>; both contributed to the changes in OEF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These findings demonstrated an altered cerebral oxygen metabolism in preterm brain, suggesting a potential role of MRI\u2013based oxygenation measurement in the assessment of transfusion and intervention for preterm neonates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cns3.20081","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T08:49:44Z","timestamp":1730105384000},"page":"269-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study"],"prefix":"10.1002","volume":"2","author":[{"given":"Zixuan","family":"Lin","sequence":"first","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dengrong","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Russell H. 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