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.

scholarly journals Cranial ultrasound in detection of neurological lesions in preterm neonates in a tertiary center in North Kerala, India

2017 ◽  
Vol 4 (3) ◽  
pp. 804 ◽  
Author(s):  
Kavya M. K. ◽  
Radhamani K. V. ◽  
Mahesh P.
Keyword(s):  
Gestational Age ◽  
Brain Injuries ◽  
Radiology Department ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Medical College ◽  
Non Invasive ◽  
Tertiary Center ◽  
The Central Nervous System ◽  
Neurodevelopmental Abnormalities

Background: Incomplete formation and maturation of the central nervous system makes it extremely vulnerable to injury, in the case of premature neonates. This can result in a broad range of neurodevelopmental abnormalities. Cranial ultrasound is a sensitive tool for the early detection of these. Hence the present study was undertaken to assess the prevalence of neurosonological abnormality in preterm infants. The aims of the study were to identify and enumerate the neurosonographic features, to assess the severity of brain injuries by grading the neurosonographic findings and to correlate the clinical presentations with the neurosonographic findings.Methods: The present study was conducted in Department of Radiodiagnosis, Pariyaram Medical College. It consisted of all preterm neonates (less than 37 weeks of gestational age) referred to the Radiology department. The initial scan will be done as soon as possible (within 2 weeks of birth) followed by a repeat scan of the same infants at 36 weeks of corrected age, and at 8weeks post-partum.Results: A total of 100 neonates with gestational age varying from 29 to 37 weeks were studied, with the birth weight varying from 1.5 to 1.9 kg. The most common abnormality found on neurosonogram was germinal-matrix haemorrhage, followed by periventricular leukomalacia.Conclusions: Real time sonography is a sensitive non-invasive initial investigation for the detection of various brain lesions in the preterm neonates.

scholarly journals Value of transcranial ultrasound screening for the preterm in the neonatal ICU

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S B Ali ◽  
A S Abdelrahman ◽  
M I Hassan
Keyword(s):  
Gestational Age ◽  
Imaging Modality ◽  
Periventricular Leukomalacia ◽  
Transcranial Ultrasound ◽  
Radiology Department ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Ultrasound Screening ◽  
Agenesis Of Corpus Callosum ◽  
Neonatal Icu

Abstract Background preterm neonates less than 37 weeks of gestational age are more liable to hemorrhagic and ischemic brain lesions due to the immaturity of capillary bed, cerebral auto-regulation and vascular anastomosis, with consequent adverse outcome, poor cognitive development, and cerebral palsy. Cranial ultrasound is a safe imaging modality with no need to radiation exposure or sedation. Aim of the Work to evaluate the usefulness of universal cranial ultrasound screening in preterm neonates in the neonatal ICU with gestational age between 28 and 37 weeks to detect the different intra cranial pathologies in this pediatric group. Patients and Methods After taking approval by the Radiology Department Committee of the Faculty of Medicine, Ain shams University, the current study was performed on all preterm neonates (50) admitted to neonatal ICU in Ain shams hospital between 28 and 37 weeks of gestational age, between the third and seventh day of life, from July 1, 2017 to April 1, 2018 were included in the study. Results The study showed normal transcrainal ultrasound (72.0%), Germinal matrix hemorrhage (10.0%), Intraventricular hemorrhage (6.0%), Periventricular leukomalacia (6.0%), Congenital anomalies is Dandy walker malformation (2.0%), Chiari malformation (0.0%), Agenesis of corpus callosum (2.0%) and Porencephalic cyst (2.0%) of finding of ultrasound. Conclusion The importance of preterm screening by cranial ultrasound is sustained by the observation that most preterm neonates with abnormal CUS are usually asymptomatic. Only occasionally these patients develop symptoms.Linear high frequency probe of ultrasound was of great benefit in better visualization of anatomical details and mild pathological lesions.

Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants

1999 ◽  
Vol 134 (4) ◽  
pp. 492-498 ◽  
Author(s):  
Cécile Besson Duvanel ◽  
Claire-Lise Fawer ◽  
Jacques Cotting ◽  
Patrick Hohlfeld ◽  
Jean-Marie Matthieu
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Psychomotor Development ◽  
Brain Growth ◽  
Long Term Effects ◽  
Neonatal Hypoglycemia

Universal Cranial Ultrasound Screening in Preterm Infants With Gestational Age 33-36 Weeks. A Retrospective Analysis of 724 Newborns

2014 ◽  
Vol 51 (6) ◽  
pp. 790-794 ◽  
Author(s):  
Elisa Ballardini ◽  
Anna Tarocco ◽  
Alessandro Baldan ◽  
Elisa Antoniazzi ◽  
Giampaolo Garani ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Preterm Infants ◽  
Gestational Age ◽  
Cranial Ultrasound ◽  
Ultrasound Screening

scholarly journals Does ventricle size contribute to cognitive outcomes in posthemorrhagic hydrocephalus? Role of early definitive intervention

2021 ◽  
pp. 1-11
Author(s):  
Mounica Paturu ◽  
Regina L. Triplett ◽  
Siddhant Thukral ◽  
Dimitrios Alexopoulos ◽  
Christopher D. Smyser ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Brain Mri ◽  
Neurodevelopmental Outcome ◽  
Optimal Time ◽  
Preterm Neonates ◽  
Third Ventriculostomy ◽  
Cranial Ultrasound ◽  
Ventricular Size ◽  
Posthemorrhagic Hydrocephalus ◽  
Ventricle Size

OBJECTIVE Posthemorrhagic hydrocephalus (PHH) is associated with significant morbidity, smaller hippocampal volumes, and impaired neurodevelopment in preterm infants. The timing of temporary CSF (tCSF) diversion has been studied; however, the optimal time for permanent CSF (pCSF) diversion is unknown. The objective of this study was to determine whether cumulative ventricle size or timing of pCSF diversion is associated with neurodevelopmental outcome and hippocampal size in preterm infants with PHH. METHODS Twenty-five very preterm neonates (born at ≤ 32 weeks’ gestational age) with high-grade intraventricular hemorrhage (IVH), subsequent PHH, and pCSF diversion with a ventriculoperitoneal shunt (n = 20) or endoscopic third ventriculostomy (n = 5) were followed until 2 years of age. Infants underwent serial cranial ultrasounds from birth until 1 year after pCSF diversion, brain MRI at term-equivalent age, and assessment based on the Bayley Scales of Infant and Toddler Development, Third Edition, at 2 years of age. Frontooccipital horn ratio (FOHR) measurements were derived from cranial ultrasounds and term-equivalent brain MRI. Hippocampal volumes were segmented and calculated from term-equivalent brain MRI. Cumulative ventricle size until the time of pCSF diversion was estimated using FOHR measurements from each cranial ultrasound performed prior to permanent intervention. RESULTS The average gestational ages at tCSF and pCSF diversion were 28.9 and 39.0 weeks, respectively. An earlier chronological age at the time of pCSF diversion was associated with larger right hippocampal volumes on term-equivalent MRI (Pearson’s r = −0.403, p = 0.046) and improved cognitive (r = −0.554, p = 0.047), motor (r = −0.487, p = 0.048), and language (r = −0.414, p = 0.021) outcomes at 2 years of age. Additionally, a smaller cumulative ventricle size from birth to pCSF diversion was associated with larger right hippocampal volumes (r = −0.483, p = 0.014) and improved cognitive (r = −0.711, p = 0.001), motor (r = −0.675, p = 0.003), and language (r = −0.618, p = 0.011) outcomes. There was no relationship between time to tCSF diversion or cumulative ventricle size prior to tCSF diversion and neurodevelopmental outcome or hippocampal size. Finally, a smaller cumulative ventricular size prior to either tCSF diversion or pCSF diversion was associated with a smaller ventricular size 1 year after pCSF diversion (r = 0.422, p = 0.040, R2 = 0.178 and r = 0.519, p = 0.009, R2 = 0.269, respectively). CONCLUSIONS In infants with PHH, a smaller cumulative ventricular size and shorter time to pCSF diversion were associated with larger right hippocampal volumes, improved neurocognitive outcomes, and reduced long-term ventriculomegaly. Future prospective randomized studies are needed to confirm these findings.

scholarly journals CRANIAL ULTRASOUND: EFFICIENT SCREENING TOOL FOR EARLY DETECTION OF BRAIN INJURY IN PRETERM INFANTS

2021 ◽  
Vol 7 (1) ◽  
pp. 7-11
Author(s):  
Dini Rachma Erawati ◽  
Yuyun Yueniwati
Keyword(s):  
Brain Injury ◽  
Early Detection ◽  
Preterm Infants ◽  
Gestational Age ◽  
Screening Tool ◽  
Mode Of Delivery ◽  
Fisher Exact Test ◽  
Cranial Ultrasound ◽  
Cross Sectional ◽  
Ultrasound Findings

Background: Cranial ultrasound becomes an important diagnostic tool to evaluate brain injury in infants. Brain injury is a major complication for preterm birth. The brain injury of preterm infants differs from that of a term infant. Brain injury has correlation with gestational age and mode of delivery. Objective: To analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery and to reveal if cranial ultrasound can be used to detect brain injury in premature infants. Methods: An observational analytic study using cross-sectional design took place in Saiful Anwar Hospital Malang, Indonesia. 38 healthy preterm infants underwent cranial ultrasound examination within the first four day of life. Fisher Exact test was used to analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery. Results: Most of the healthy preterm infants (89.5%) were ≥ 32 weeks gestational age, and 52.6% of samples had caesarean section as their mode of delivery. There were three abnormal findings in cranial ultrasound; increased periventricular echogenic (5.3%), increased parenchym echogenic (5.3%), and indistinguishable of gray-white matter differentiation (5.3%). There was no significant correlation between abnormal cranial ultrasound findings with gestational age and mode of delivery (p= 0.202; p= 0.218). Conclusion: There were abnormal cranial ultrasound findings in some healthy preterm infants despite no significant correlation between ultrasound findings with gestational age and mode of delivery. Cranial ultrasound in preterm infants could become a screening tool for early detection of brain injury.

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 CYP2C9*2 is associated with indomethacin treatment failure for patent ductus arteriosus

2019 ◽  
Vol 20 (13) ◽  
pp. 939-946
Author(s):  
Sydney R Rooney ◽  
Elaine L Shelton ◽  
Ida Aka ◽  
Christian M Shaffer ◽  
Ronald I Clyman ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Treatment Failure ◽  
Preterm Infants ◽  
Gestational Age ◽  
Genetic Factors ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Multicenter Cohort Study ◽  
Patent Ductus ◽  
Indomethacin Treatment

Aims: To identify clinical andgenetic factors associated with indomethacin treatment failure in preterm neonates with patent ductus arteriosus (PDA). Patients & Methods: This is a multicenter cohort study of 144 preterm infants (22–32 weeks gestational age) at three centers who received at least one treatment course of indomethacin for PDA. Indomethacin failure was defined as requiring subsequent surgical intervention. Results: In multivariate analysis, gestational age (AOR 0.76, 95% CI 0.60–0.96), surfactant use (AOR 9.77, 95% CI 1.15–83.26), and CYP2C9*2 (AOR 3.74; 95% CI 1.34–10.44) were each associated with indomethacin failure. Conclusion: Age, surfactant use, and CYP2C9*2 influence indomethacin treatment outcome in preterm infants with PDA. This combination of clinical and genetic factors may facilitate targeted indomethacin use for PDA.

Epidemiology of Inguinal Hernia in Preterm Neonates

PEDIATRICS ◽  
1986 ◽  
Vol 77 (2) ◽  
pp. 246-247 ◽  
Author(s):  
KEITH J. PEEVY ◽  
FELICITY A. SPEED ◽  
CHARLES J. HOFF
Keyword(s):  
Inguinal Hernia ◽  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Preterm Neonates ◽  
Intrauterine Growth ◽  
Inguinal Hernias

We have studied the epidemiology of inguinal hernias in preterm infants. Inguinal hernias occur with increased frequency in infants ≤32 weeks' gestational age or ≤1,250 g birth weight. Among infants ≤32 weeks' gestational age, intrauterine growth retardation significantly increases the risk for development of inguinal hernias, especially in male infants. Our data demonstrate a previously unrecognized association between neonatal inguinal hernia and intrauterine growth retardation.

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