Garcés Iñigo Enrique, Llorens Salvador Roberto, Escrig Raquel, Hervás David, Vento Máximo, Martí-Bonmatí Luis
Department of Radiology, Hospital de Sagunto, Valencia, Spain.
Department of Radiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
J Ultrasound Med. 2021 Apr;40(4):795-804. doi: 10.1002/jum.15464. Epub 2020 Sep 2.
To demonstrate the feasibility of 2-dimensional brain ultrasound shear wave elastography (SWE) and to define the average elasticity values of the gray and white matter in term neonates.
This work was a prospective observational single-center study including 55 healthy term neonates consecutively recruited in the maternity ward between the second and third postnatal days. All were successfully evaluated with a cerebral SWE examination performed with a multifrequency 4-9-MHz transducer. Bilateral sagittal planes of the thalamus and corona radiata were used to measure stiffness using a quantitative SWE method. Several elastograms with 5 to 15 nonoverlapping areas were obtained from the 2 different anatomic locations. The 5 most central measurements were averaged as representative values.
The 55 neonates ranged from 37 to 40 weeks' gestation. The estimated mean velocity values of the thalamus (1.17 m/s; 95% confidence interval, 1.13, 1.22 m/s) and corona radiata (1.60 m/s; 95% confidence interval, 1.57, 1.64 m/s) were statistically different (P < .001). There was no significant influence of laterality, gestational age, cephalic perimeter, sex, length, or type of delivery on the stiffness measurements.
Brain ultrasound SWE is feasible and allows measurements of neonatal brain elasticity. The elasticity of the thalamus and corona radiata at the frontal white matter in healthy term neonates is different. The knowledge of normal SWE ranges in term neonates allows comparative studies under pathologic conditions.
证明二维脑超声剪切波弹性成像(SWE)的可行性,并确定足月儿脑灰质和白质的平均弹性值。
本研究为前瞻性观察性单中心研究,连续纳入55例在产后第2天至第3天在产科病房招募的健康足月儿。所有患儿均使用多频率4-9MHz探头成功进行了脑SWE检查。采用定量SWE方法,通过丘脑和放射冠的双侧矢状面测量硬度。从2个不同的解剖位置获取5至15个非重叠区域的多个弹性图。将5个最中心的测量值平均作为代表值。
55例新生儿的孕周为37至40周。丘脑的估计平均速度值(1.17m/s;95%置信区间,1.13,1.22m/s)和放射冠的估计平均速度值(1.60m/s;95%置信区间,1.57,1.64m/s)在统计学上有差异(P<0.001)。侧别、孕周、头围、性别、身长或分娩方式对硬度测量无显著影响。
脑超声SWE是可行的,能够测量新生儿脑弹性。健康足月儿额叶白质处丘脑和放射冠的弹性不同。了解足月儿正常SWE范围有助于在病理条件下进行对比研究。