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Cerebral superb microvascular imaging in preterm neonates: in vivo evaluation of thalamic, striatal, and extrastriatal angioarchitecture

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

To explore the potential of superb microvascular imaging (SMI) in visualizing brain microvessels in preterm neonates of different gestational ages (GA).

Methods

In this retrospective, observational pilot study, 15 preterm newborns were equally divided into GA groups: extremely (GA < 28 weeks), very (28–31 weeks), and moderate to late (32–37 weeks) preterm. All patients underwent conventional transcranial ultrasounds during the first day of life following the American Institute of Ultrasound in Medicine practice guidelines. SMI was then performed; based on their SMI morphology and location, brain microvessels were classified as extrastriatal (cortical and medullary), striatal, or thalamic. Two examiners independently classified vessels as visible or invisible. To assess the association between vessel visibility and GA, binomial logistic regression analysis (separate for each microvessel group) was performed, taking visibility as a dependent variable and both examiners and GA as predictor variables.

Results

A statistically significant difference among GA groups was found in sex (P = 0.030), birth weight (P = 0.007), and Apgar score within 1 min after birth (P = 0.024). Microvascular visibility increased with GA for superficial vessels (P < 0.05 for both cortical and medullary), while striatal and thalamic vessels were visible in all neonates irrespective of their GA.

Conclusions

SMI technology shows promise to assess brain microvasculature in preterm neonates, even potentially providing data on early brain development.

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Abbreviations

cSMI:

Color superb microvascular imaging

EP:

Extremely preterm

GA:

Gestational age

IRR:

Inter-reader reliability

MLP:

Moderate to late preterm

MRI:

Magnetic resonance imaging

mSMI:

Monochrome superb microvascular imaging

SMI:

Superb microvascular imaging

US:

Ultrasound

VP:

Very preterm

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Neuroradiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, BG, Italy

    A. Barletta & S. Gerevini

  2. Department of Radiology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, BG, Italy

    M. Balbi, A. Surace & S. Sironi

  3. School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy

    M. Balbi, A. Surace, S. Radaelli, F. Musto & S. Sironi

  4. Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Gian Battista Camozzi 3, 24020, Ranica, BG, Italy

    A. Caroli

  5. Neonatal Intensive Care Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, BG, Italy

    S. Radaelli, F. Musto, M. Saruggia & G. Mangili

Authors
  1. A. Barletta
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  2. M. Balbi
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  3. A. Surace
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  4. A. Caroli
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  7. M. Saruggia
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  8. G. Mangili
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  9. S. Gerevini
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  10. S. Sironi
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Correspondence to A. Barletta.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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

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Keypoints

- Superb microvascular imaging (SMI) provides a noninvasive tool for assessing brain microvessels in preterm neonates, potentially supporting the diagnosis of brain vascular disorders and monitoring of normal brain development.

- Cortical and medullary vessel visibility increases with gestational age (GA) (P < 0.05), while striatal and thalamic vessels are visible irrespective of GA.

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Barletta, A., Balbi, M., Surace, A. et al. Cerebral superb microvascular imaging in preterm neonates: in vivo evaluation of thalamic, striatal, and extrastriatal angioarchitecture. Neuroradiology 63, 1103–1112 (2021). https://doi.org/10.1007/s00234-021-02634-w

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  • DOI: https://doi.org/10.1007/s00234-021-02634-w

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