Kishimoto Jessica, Fenster Aaron, Lee David S C, de Ribaupierre Sandrine
University of Western Ontario, Department of Medical Biophysics, London, Ontario, Canada.
University of Western Ontario, Robarts Research Institute, Imaging Research Laboratories, London, Ontario, Canada.
J Med Imaging (Bellingham). 2018 Apr;5(2):026001. doi: 10.1117/1.JMI.5.2.026001. Epub 2018 Jun 26.
Dilatation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage. This posthemorrhagic ventricle dilatation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure, and without treatment can lead to death. Two-dimensional ultrasound (US) through the fontanelles of the patients is serially acquired to monitor the progression of PHVD. These images are used in conjunction with clinical experience and physical exams to determine when interventional therapies such as needle aspiration of the built up cerebrospinal fluid (ventricle tap, VT) might be indicated for a patient; however, quantitative measurements of the ventricles size are often not performed. We describe the potential utility of the quantitative three-dimensional (3-D) US measurements of ventricle volumes (VVs) in 38 preterm neonates to monitor and manage PHVD. Specifically, we determined 3-D US VV thresholds for patients who received VT in comparison to patients with PHVD who resolve without intervention. In addition, since many patients who have an initial VT will receive subsequent interventions, we determined which PHVD patients will receive additional VT after the initial one has been performed.
脑室扩张是早产儿脑室内出血的常见病症。这种出血后脑室扩张（PHVD）可因颅内压升高导致缺血性损伤，进而造成终身神经功能障碍，若不治疗则会导致死亡。通过患儿囟门进行二维超声（US）检查，并连续采集图像以监测PHVD的进展情况。这些图像结合临床经验和体格检查，用于确定何时可能需要对患儿进行诸如穿刺抽取积聚的脑脊液（脑室穿刺，VT）等介入治疗；然而，脑室大小的定量测量往往并未进行。我们描述了对38例早产儿进行脑室容积（VV）的三维（3-D）超声定量测量在监测和管理PHVD方面的潜在用途。具体而言，我们确定了接受VT治疗的患儿与未经干预自行好转的PHVD患儿的三维超声VV阈值。此外，由于许多最初接受VT治疗的患儿会接受后续干预，我们还确定了哪些PHVD患儿在首次进行VT治疗后还会接受额外的VT治疗。
