Sheikh Maryam, Shabbir Sadia
Department of Imaging and Radiology, Children's Hospital Lahore, University of Child Health Sciences, Lahore, PAK.
Department of Radiology, Children's Hospital Lahore, University of Child Health Sciences, Lahore, PAK.
Cureus. 2024 Nov 15;16(11):e73732. doi: 10.7759/cureus.73732. eCollection 2024 Nov.
Background and objective Intracranial hemorrhage (ICH) and white-matter damage are the main brain injuries in preterm infants. Magnetic resonance imaging (MRI) is the best way to examine cerebral bleeding. The evidence on cranial ultrasound diagnostic accuracy in neonates is limited in Pakistani publications, which show variability in evidence, necessitating the present study. The aim is to find out the diagnostic accuracy of cranial ultrasound for detecting ICH in preterm neonates, taking MRI as the gold standard. Methodology A cross-sectional study was carried out in the Department of Radiology, The Children's Hospital, Lahore, Pakistan, from June 19, 2018 to December 18, 2018. The study involved 103 preterm neonates of both genders aged between 1 and 27 days and presenting with suspicion of ICH. The cranial ultrasound with MRI (gold standard) was used to diagnose ICH, and the results of the cranial ultrasound were assessed accordingly. The diagnostic performance of ultrasound was estimated using parameters, e.g., sensitivity, specificity, accuracy, and positive and negative predictive values. The p < 0.05 was taken as statistically significant. Results The neonates had a mean age of 9.9 ± 6.6 days. There were 53 (51.5%) male and 50 (48.5%) female neonates. The cranial ultrasound diagnosed ICH in 39 (37.9%) neonates, which is confirmed by MRI as the gold standard. Cranial ultrasound had 100.0% sensitivity, 90.62% specificity, 94.17% accuracy, 86.67% positive predictive value, and 100.0% negative predictive value for detecting ICH in preterm neonates. Similar diagnostic performance was seen across age and gender groups (p > 0.05). Conclusion Cranial ultrasound was 100% sensitive, 90.6% specific, and 94.2% accurate in identifying cerebral bleeding in preterm neonates. The noninvasive, ionizing radiation-free nature and availability at the bedside of cranial ultrasound make it a promising future modality.
背景与目的 颅内出血（ICH）和白质损伤是早产儿主要的脑损伤类型。磁共振成像（MRI）是检查脑内出血的最佳方法。在巴基斯坦的出版物中，关于新生儿头颅超声诊断准确性的证据有限，且证据存在差异，因此有必要开展本研究。目的是以MRI作为金标准，探究头颅超声检测早产儿颅内出血的诊断准确性。方法 于2018年6月19日至2018年12月18日在巴基斯坦拉合尔儿童医院放射科开展了一项横断面研究。该研究纳入了103例年龄在1至27天、怀疑患有颅内出血的早产新生儿，男女不限。采用头颅超声联合MRI（金标准）诊断颅内出血，并据此评估头颅超声的结果。使用敏感性、特异性、准确性以及阳性和阴性预测值等参数评估超声的诊断性能。p<0.05被视为具有统计学意义。结果 这些新生儿的平均年龄为9.9±6.6天。其中男婴53例（51.5%），女婴50例（48.5%）。头颅超声诊断出39例（37.9%）新生儿患有颅内出血，经MRI作为金标准证实。头颅超声检测早产儿颅内出血的敏感性为100.０%，特异性为90.62%，准确性为94.17%，阳性预测值为86.67%，阴性预测值为100.０%。在不同年龄和性别组中观察到了相似的诊断性能（p>0.05）。结论 头颅超声在识别早产儿脑内出血方面敏感性为100%，特异性为90.6%，准确性为94.2%。头颅超声具有无创、无电离辐射以及可在床边使用的特点，使其成为一种很有前景的未来检查方式。
