Sero Leyla, Tuncel Duygu, Karaca Mehmet Salih, Okur Nilufer
Clinics of Pediatrics, Gazi Yaşargil Training and Research Hospital, 21090 Diyarbakır, Turkey.
Clinics of Neonatology, Gazi Yaşargil Training and Research Hospital, 21090 Diyarbakır, Turkey.
Children (Basel). 2025 Jun 9;12(6):745. doi: 10.3390/children12060745.
Cranial Doppler ultrasonography (DS) is a non-invasive method for evaluating cerebral hemodynamics in neonates with perinatal asphyxia (PA). This study aimed to assess whether cerebral vascular resistance indices (RIs) measured within the first 24 h of life can predict the severity of brain injury.
DS was performed on the anterior cerebral artery (ACA) and middle cerebral artery (MCA) between 6 and 24 h after birth in newborns diagnosed with PA. Prognostic value was evaluated by comparing RI values with cranial magnetic resonance imaging (MRI) results.
Of the 107 infants included in the study, 11 (10.3%) had severe brain damage, 27 (25.2%) had mild and 20 (18.7%) had moderate changes. The mean ACA RI was 0.61 ± 0.15 in the severe group and 0.70 ± 0.12 in the mild-moderate group ( = 0.023). MCA RI was 0.63 ± 0.20 and 0.71 ± 0.13, respectively. ROC analysis showed an area under the curve (AUC) of 0.901 for ACA RI with a cut-off of 0.58 (84% sensitivity and 84% specificity), and 0.874 for MCA RI with a cut-off of 0.59 (83% sensitivity and 84% specificity).
Early ACA and MCA RI measurements via Doppler ultrasonography may serve as valuable predictors of brain injury severity in neonates with PA and should be considered alongside other clinical and imaging findings.
颅多普勒超声检查（DS）是评估围产期窒息（PA）新生儿脑血流动力学的一种非侵入性方法。本研究旨在评估出生后24小时内测量的脑血管阻力指数（RI）是否能预测脑损伤的严重程度。
对诊断为PA的新生儿在出生后6至24小时内进行前脑动脉（ACA）和中脑动脉（MCA）的DS检查。通过将RI值与头颅磁共振成像（MRI）结果进行比较来评估预后价值。
在纳入研究的107例婴儿中，11例（10.3%）有严重脑损伤，27例（25.2%）有轻度损伤，20例（18.7%）有中度改变。严重组的平均ACA RI为0.61±0.15，轻-中度组为0.70±0.12（P = 0.023）。MCA RI分别为0.63±0.20和0.71±0.13。ROC分析显示，ACA RI的曲线下面积（AUC）为0.901，截断值为0.58（敏感性84%，特异性84%），MCA RI的AUC为0.874，截断值为0.59（敏感性83%，特异性84%）。
通过多普勒超声早期测量ACA和MCA RI可能是PA新生儿脑损伤严重程度的有价值预测指标，应与其他临床和影像学检查结果一起考虑。
