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Developmental outcomes of very low birthweight infants with non-hemorrhagic ventricular dilatations and the relationships thereof with absolute brain volumes measured via two-dimensional ultrasonography

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Abstract

Purpose

We calculated the brain volumes of preterm infants using two-dimensional cranial ultrasonography and explored the relationships thereof with neurodevelopment.

Methods

Cranial measurements were derived using routine ultrasonographic scanning. The brain was considered to be an ellipsoid and estimated absolute brain volumes (EABVs) were calculated by substracting the volumes of the two lateral ventricles from the total brain volumes.

Results

We enrolled preterm infants of mean gestational age 28 ± 2 weeks and mean birthweight 973 ± 187 g. Twenty-one exhibited dilated ventricles; their EABVs were lower than normal (206 ± 11 cm3 vs. 275 ± 17 cm3, p < 0.001). The mental development indices were similar (74 ± 5 vs. 78 ± 14, p = 0.069), but the psychomotor development indices (PDIs) differed significantly (77 ± 7 vs. 86 ± 17, p = 0.001). We found a slight positive correlation between the PDI and EABV (r = + 0.258, p = 0.012).

Conclusion

The EABV can be calculated using two-dimensional measurements and low EABV found to be associated with poor neurological outcomes.

Trial registration

NCT02848755

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

APD, FOD:

Postero-anterior diameter

BPDia:

Bi-parietal diameter

cPVL:

Cystic periventricular leukomalacia

CrUS:

Cranial ultrasonography

EABV:

Estimated absolute brain volume

ICH:

Intracranial height

MRI:

Magnetic resonance imaging

NICU:

Neonatal intensive care unit

TOD:

Thalamo-occipital distance

US:

Ultrasonography

VH:

Ventricular height

VI:

Ventricular index

2D:

Two-dimensional

3D:

Three-dimensional

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Author information

Authors and Affiliations

  1. Department of Neonatology, NICU, University of Health Sciences, City Hospital MH5, Çankaya, 06800, Ankara, Ankara, Turkey

    Gülsüm Kadıoğlu Şimşek, Fuat Emre Canpolat, Mehmet Büyüktiryaki, Esin Okman, Merve Keser & H. Gözde Kanmaz Kutman

  2. Developmental Pediatrics Unit, TOBB University, Çankaya, 06800, Ankara, Turkey

    Zeynep Üstünyurt

Authors
  1. Gülsüm Kadıoğlu Şimşek
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  2. Fuat Emre Canpolat
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  3. Mehmet Büyüktiryaki
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  4. Esin Okman
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  5. Merve Keser
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  6. Zeynep Üstünyurt
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  7. H. Gözde Kanmaz Kutman
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Contributions

GKS and FEC made crUS, EO and MK entered data to database, GKS and FEC analyzed them, HGKK and MB helped patient evaluation and data analysis, FEC and GKS wrote the manuscript, and ZÜ made developmental assessments.

Corresponding author

Correspondence to Gülsüm Kadıoğlu Şimşek.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All study approvals (local institutional review board: Zekai Tahir Burak Hospital Specialty Educational Review Board [TUEK]; ethics board: Zekai Tahir Burak Hospital Clinical Ethics Committee) and parental consent (in verbal form because CrUS is routine during hospitalization in the NICU) were received prior to study initiation.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

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What is already known?

1. Ventricular dilatation in preterm infants is associated with poor neurological outcomes.

2. Brain volume can be calculated using advanced imaging techniques such as magnetic resonance imaging.

3. Magnetic resonance imaging results confirm measurements made using transfontanelle cranial ultrasonography.

What is new?

1. Brain volume can be calculated using two-dimensional ultrasonographic measurements in low-resource settings.

2. The subtraction of ventricular volumes from the total brain volume yields an absolute brain volume.

3. The estimated absolute brain volumes of preterm infants can be obtained using two-dimensional ultrasonographic measurements and correlate positively with neurodevelopmental scores.

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Şimşek, G.K., Canpolat, F.E., Büyüktiryaki, M. et al. Developmental outcomes of very low birthweight infants with non-hemorrhagic ventricular dilatations and the relationships thereof with absolute brain volumes measured via two-dimensional ultrasonography. Childs Nerv Syst 36, 1231–1237 (2020). https://doi.org/10.1007/s00381-019-04464-x

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  • DOI: https://doi.org/10.1007/s00381-019-04464-x

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