scholarly journals Quantitative assessment of myelination patterns in preterm neonates using T2-weighted MRI

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Siying Wang ◽  
Christian Ledig ◽  
Joseph V. Hajnal ◽  
Serena J. Counsell ◽  
Julia A. Schnabel ◽  
...  
Keyword(s):  
Gestational Age ◽  
Markov Random Fields ◽  
Quantitative Assessment ◽  
Mean Squared Error ◽  
Developmental Process ◽  
Growth Models ◽  
Brain Structures ◽  
Magnetic Resonance Images ◽  
Brain Maturation ◽  
Preterm Neonates

Abstract Myelination is considered to be an important developmental process during human brain maturation and closely correlated with gestational age. Quantitative assessment of the myelination status requires dedicated imaging, but the conventional T2-weighted scans routinely acquired during clinical imaging of neonates carry signatures that are thought to be associated with myelination. In this work, we develop a quatitative marker of progressing myelination for assessment preterm neonatal brain maturation based on novel automatic segmentation method for myelin-like signals on T2-weighted magnetic resonance images. Firstly we define a segmentation protocol for myelin-like signals. We then develop an expectation-maximization framework to obtain the automatic segmentations of myelin-like signals with explicit class for partial volume voxels whose locations are configured in relation to the composing pure tissues via second-order Markov random fields. The proposed segmentation achieves high Dice overlaps of 0.83 with manual annotations. The automatic segmentations are then used to track volumes of myelinated tissues in the regions of the central brain structures and brainstem. Finally, we construct a spatio-temporal growth models for myelin-like signals, which allows us to predict gestational age at scan in preterm infants with root mean squared error 1.41 weeks.

scholarly journals Segmentation of Myelin-like Signals on Clinical MR Images for Age Estimation in Preterm Infants

2018 ◽  
Author(s):  
Maria Deprez ◽  
Siying Wang ◽  
Christian Ledig ◽  
Joseph V. Hajnal ◽  
Serena J. Counsell ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Age Estimation ◽  
Markov Random Fields ◽  
Developmental Process ◽  
Growth Models ◽  
Perinatal Period ◽  
Magnetic Resonance Images ◽  
Brain Maturation ◽  
Initial Segmentation ◽  
Spatio Temporal

AbstractMyelination is considered to be an important developmental process during human brain maturation and closely correlated with gestational age. Assessment of the myelination status requires dedicated imaging, but the conventional T2-weighted scans routinely acquired during clinical imaging of neonates carry signatures that are thought to be associated with myelination. In this work, we propose a new segmentation method for myelin-like signals on T2-weighted magnetic resonance images that could be used to assess neonatal brain maturation in clinical practice. Firstly we define a segmentation protocol for myelin-like signals, and delineate manual annotations according to this protocol. We then develop an expectation-maximization framework through which we obtain the automatic segmentations of myelin-like signals. We incorporate an explicit class for partial volume voxels whose locations are configured in relation to the composing pure tissues via second-order Markov random fields. We conduct experiments in the thalami and brainstem where the majority of myelination occurs during the perinatal period for 16 test subjects aged between 29 and 44 gestational weeks. The proposed method performs accurately and robustly in both regions with respect to the manual annotations over a range of intensity percentile thresholds that are used to generate the initial segmentation estimates. Finally, we construct spatio-temporal growth models for myelin-like signals in the thalami and brain-stem to demonstrate the applicability of the proposed method for age estimation in preterm infants.

Brain GRowth Evaluation Assessed with Transfontanellar (B-GREAT) ultrasound. Old and new bedside markers to estimate cerebral growth in preterm infants: a pilot study

2021 ◽  
Author(s):  
Roberta Arena ◽  
Francesca Gallini ◽  
Domenico Umberto De Rose ◽  
Francesca Conte ◽  
Luca Giraldi ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Preterm Infants ◽  
Gestational Age ◽  
Intraclass Correlation ◽  
Growth Curves ◽  
Brain Structures ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Brain Growth ◽  
Growth Evaluation

Objective: We aimed to investigate the feasibility of evaluating overall preterm brain growth using a gathered set of measurements of brain structures in standard cranial ultrasound planes. We called this method of assessment Brain GRowth Evaluation Assessed with Transfontanellar ultrasound (B-GREAT). Study design: In this prospective observational cohort study, cranial ultrasound was regularly performed (on day 1, 2, 3, 7 of life and then weekly until discharge and at term) in preterm infants born with a gestational age less than 32 weeks. We evaluated Corpus Callosum (CC) length, Corpus Callosum-Fastigium (CCF) length, Anterior Horn Width (AHW), Frontal White Matter (FWM) height, Total brain Surface (TBS), Deep Grey Matter (DGM) height, Hemisphere Height (HH), Transverse Cerebellar Diameter in the axial view (TCDax) and coronal view (TCDcor). Measurements obtained were used to develop growth charts for B-GREAT markers as a function of postmenstrual age. Reproducibility of B-GREAT markers was studied. Results: A total of 528 cranial ultrasounds was performed in 80 neonates (median birth gestational age: 28+5 weeks, interquartile range: 27+3 to 30+5). The intraclass correlation coefficients for intra-observer and inter-observer analyses showed substantial agreement for all B-GREAT markers. Growth curves for B-GREAT markers were developed. Conclusion: B-GREAT is a feasible and reproducible method for bedside monitoring of the growth of the main brain structures in preterm neonates.

Acute kidney injury in preterm neonates with ≤30 weeks of gestational age and its risk factors

2019 ◽  
Vol 71 (5) ◽  
Author(s):  
Rita Ladeiras ◽  
Filipa Flor-De-Lima ◽  
Henrique Soares ◽  
Bárbara Oliveira ◽  
Hercília Guimarães
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Gestational Age ◽  
Kidney Injury ◽  
Preterm Neonates

scholarly journals Automated Head Tissue Modelling Based on Structural Magnetic Resonance Images for Electroencephalographic Source Reconstruction

2021 ◽  
Author(s):  
Gaia Amaranta Taberna ◽  
Jessica Samogin ◽  
Dante Mantini
Keyword(s):  
Magnetic Resonance ◽  
Brain Structures ◽  
Magnetic Resonance Images ◽  
Head Model ◽  
Source Reconstruction ◽  
Mr Images ◽  
Tissue Segmentation ◽  
Mr Image ◽  
Eeg Recordings ◽  
Tissue Modelling

AbstractIn the last years, technological advancements for the analysis of electroencephalography (EEG) recordings have permitted to investigate neural activity and connectivity in the human brain with unprecedented precision and reliability. A crucial element for accurate EEG source reconstruction is the construction of a realistic head model, incorporating information on electrode positions and head tissue distribution. In this paper, we introduce MR-TIM, a toolbox for head tissue modelling from structural magnetic resonance (MR) images. The toolbox consists of three modules: 1) image pre-processing – the raw MR image is denoised and prepared for further analyses; 2) tissue probability mapping – template tissue probability maps (TPMs) in individual space are generated from the MR image; 3) tissue segmentation – information from all the TPMs is integrated such that each voxel in the MR image is assigned to a specific tissue. MR-TIM generates highly realistic 3D masks, five of which are associated with brain structures (brain and cerebellar grey matter, brain and cerebellar white matter, and brainstem) and the remaining seven with other head tissues (cerebrospinal fluid, spongy and compact bones, eyes, muscle, fat and skin). Our validation, conducted on MR images collected in healthy volunteers and patients as well as an MR template image from an open-source repository, demonstrates that MR-TIM is more accurate than alternative approaches for whole-head tissue segmentation. We hope that MR-TIM, by yielding an increased precision in head modelling, will contribute to a more widespread use of EEG as a brain imaging technique.

scholarly journals Intestinal Permeability in Preterm Neonates is not Related to Gestational Age or Birth Weight. 75

1996 ◽  
Vol 40 (3) ◽  
pp. 527-527
Author(s):  
Ruurd M van Elburg ◽  
Femke M van Overbeek ◽  
Carin M Bunkers ◽  
Willem PF Fetter ◽  
Sidarto Bambang Oetomo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Intestinal Permeability ◽  
Gestational Age ◽  
Preterm Neonates

Comparison of Prophylaxis and Rescue Treatment With Curosurf in Neonates Less than 30 Weeks' Gestation: A Randomized Trial

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 768-774 ◽  
Author(s):  
Johannes Egberts ◽  
J. Peter de Winter ◽  
Gunnar Sedin ◽  
Martin J.K. de Kleine ◽  
Ulf Broberger ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Gestational Age ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Expectant Management ◽  
Supplemental Oxygen ◽  
Preterm Neonates ◽  
Transcutaneous Oxygen ◽  
Prophylaxis Group ◽  
Rescue Treatment

Objective. The aim of this randomized clinical trial was to evaluate the immediate effects of prophylactic administration of Curosurf and to compare outcomes after prophylactic or expectant management. Study design. Porcine surfactant (Curosurf, 200 mg/kg body weight) was administered intratracheally within 10 minutes of birth to preterm neonates with a gestational age of 26 to 29 weeks (n = 75); rescue-eligible neonates (n = 72) were initially subjected to a sham maneuver. The primary end points of the trial, evaluated at the age of 6 hours, were to obtain (1) a 40% decrease in the ratio between transcutaneous oxygen tension (tcPo2) (kPa) and fraction of inspired oxygen (Fio2), and (2) a 50% decrease in the incidence of radiologically verified respiratory distress syndrome (RDS). After 6 to 24 hours, a similar dose of surfactant was given to the neonates of both the prophylaxis and the rescue-eligible group, if they needed mechanical ventilation with an Fio2 ≥ 0.6. Results. At 6 hours the prophylaxis group had, in comparison with the rescue-eligible group, significantly higher tcPo2/Fio2 ratios (mean ± SD: 39.7 ± 15.3 vs 28.1 ± 18.1; P < .001) and less severe RDS by radiological scoring (χ2 = 14.9; P = .005). Severe RDS was present in 19% of the prophylactically treated neonates versus 32% in the rescue-eligible group (P < .05). The prophylaxis group needed shorter periods of Fio2 > 0.40 than the rescueeligible neonates (P < .01), and eight neonates of the prophylaxis group (11%) versus 23 of the rescue-eligible group (32%) qualified for rescue treatment with surfactant in the interval 6 to 24 hours (P < .01). There were no differences in the incidence or severity of pneumothorax, pulmonary interstitial emphysema, cerebral hemorrhage, periventricular leukomalacia, patent ductus arteriosus, in the duration of mechanical ventilation or time in supplemental oxygen, or in mortality. Conclusions. Subgroup analysis revealed (1) that administration of corticosteroids reduced the risk of developing neonatal RDS as effectively as did surfactant prophylaxis at birth, and (2) that prophylaxis was effective especially in neonates with gestational age <28 weeks or birth weight <1000 g, in male neonates, and in neonates who had received no antenatal treatment with corticosteriods. Our data indicate that prophylactic treatment with surfactant should be considered in high-risk neonates fulfilling these latter criteria.

Oral acetaminophen administration for patent ductus arteriosus (PDA) closure in preterm neonates

2021 ◽  
Vol 43 (3) ◽  
pp. 254-259
Author(s):  
Mahmood Samadi ◽  
Zahra Nabaee ◽  
Manizheh Mostafagharebaghi ◽  
Majid Mahalei ◽  
Elham Sheykhsaran ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Gestational Age ◽  
Statistical Significance ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Term Infants ◽  
Treatment Data ◽  
Kolmogorov Smirnov ◽  
Study Population ◽  
Patent Ductus

Background: Patent Ductus Arteriosus (PDA) is considered one of the most prevalent types of congenital heart disease. The closure of the ductus arteriosus physiologically occurs at the first 48-72 hours after the birth in healthy term infants. Different causes can result in the pathological opening of ductus arteriosus. This study aims to investigate the effect of oral acetaminophen on the closure of PDA in preterm neonates. Methods: The present study is a trial without control. Forty-five preterm neonates with a gestational age of <32 weeks were studied. Acetaminophen was orally administered with a dose of 10mg/kg every 6 hours for three days. Closure of ductus arteriosus was considered as the success of treatment. Data were analyzed using SPSS 15. Data were reported as )frequency-percent) and mean ± SD. To evaluate the normal distribution of data, we used a Kolmogorov-Smirnov test. Statistical significance was defined as P<0.05. Results: The study population consisted of 20 male and 25 female infants with the mean gestational age of 28.95 ± 1.66 weeks. Cesarean-born infants and vaginal-born infants consisted 17.8% and 82.2% of the study population, respectively. The proportion of PDA closure after administration of oralacetaminophen was 82.3%. Conclusion: The current study indicates that oral acetaminophen is highly effective in closing PDA. Considering its trivial side effects, it has the potency to be a convenient option for treating this condition.

Preterm Pulmonary Hemorrhage Is Associated with Multiple Births but Not with Intracytoplasmic Sperm Injection: A Cohort Study on Medical Records

2018 ◽  
Vol 35 (11) ◽  
pp. 1087-1092
Author(s):  
Stefanie Stierling ◽  
Ralf-Dieter Hilgers ◽  
Sonja Trepels-Kottek ◽  
Konrad Heimann ◽  
Thorsten Orlikowsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Gestational Age ◽  
Intracytoplasmic Sperm Injection ◽  
Medical Records ◽  
Ductus Arteriosus ◽  
Pulmonary Hemorrhage ◽  
Multiple Births ◽  
Preterm Neonates ◽  
Increased Risk

Objective Pulmonary hemorrhage (PH) is a severe complication in preterm neonates. This study aims to identify risk factors and comorbidities of PH. Study Design A single-center cohort study on medical records including all preterm neonates of <30 weeks' gestational age was conducted in the neonatal intensive care unit of Universitätsklinikum Aachen, Germany. The occurrence of PH served as a primary end point. Gestational age, birthweight, sex, multiple births, intracytoplasmic sperm injection (ICSI), intubation, surfactant, antenatal steroids, intraventricular hemorrhage (IVH), amniotic infection syndrome, and persistent ductus arteriosus were studied as risk factors. Results In this study, 344 preterm neonates were included, of whom 36 suffered from PH (10.5%). The mean time of the first occurrence was the third day of life (standard deviation [SD]: 1.2). On average, the patients suffered from 1.5 incidents (SD: 0.8) of PH, of whom 50% were severe. Preterm neonates born as multiples (95% confidence interval [CI]: 3.1, 26.9) and those who suffered from IVH (95% CI: 2.7, 18.9) had a significantly increased risk of PH. ICSI was not an independent risk factor. Conclusion PH is significantly associated with IVH and multiple births but not with ICSI. The identification of patients at risk allows to apply prophylactic strategies of ventilation and pharmacological treatment.

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