Comparison between 3-dimensional cranial ultrasonography and conventional 2-dimensional cranial ultrasonography in neonates: impact on reinterpretation

Abstract

PurposeThe aim of this study was to evaluate impact of 3-dimensional cranial ultrasonography (3DUS) on reinterpretation of cranial ultrasonography images in neonates in comparison with 2-dimensional cranial ultrasonography (2DUS).MethodsWe retrospectively enrolled 50 young infants who simultaneously underwent both 2DUS and 3DUS scanning from February to March 2015. Two pediatric radiologists independently reviewed both scans for overall image quality on a 5-point scale. Five features were evaluated in both scans: the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IVH), ventriculomegaly (VM), abnormality of periventricular echogenicity (PVE), and focal parenchymal lesions (FL). The concordance rate between the two scanning modes was calculated. The confidence level for each finding on a 3-point scale and the scanning time were compared between the two scanning modes. Interobserver agreement was evaluated using kappa statistics.ResultsBoth scans demonstrated similar overall image quality in terms of reinterpretation (mean scores for 2DUS and 3DUS, 4.0±0.5 and 4.0±0.7 in reviewer 1, 3.9±0.6 and 4.0±0.8 in reviewer 2, respectively). GMH, IVH, VM, and FL showed perfect concordance, while PVE showed a concordance rate of 91.4% between the two modes by both reviewers. 3DUS was associated with a higher diagnostic confidence in the evaluation of GMH, IVH, and FL than 2DUS (P<0.05) for both reviewers. For PVE, 3DUS received a significantly higher confidence score than 2DUS from one of the reviewers. The mean scanning time for 2DUS and 3DUS was 92.75 seconds and 36 seconds, respectively. Interobserver agreement for qualitative scoring was almost perfect.ConclusionIn reinterpretation, 3DUS showed very high concordance with 2DUS and a similar image quality. 3DUS also increased diagnostic confidence for several image findings and significantly decreased scan time.

Computer-aided lateral ventricular and brain volume measurements in 3D ultrasound for assessing growth trajectories in newborns and neonates

“…Quantitative volume analyses from ultrasound are limited with standard ultrasound imaging with narrow fields of views. Comparison between 2D US and 3D US was previously studied (Romero et al 2014), demonstrating that 3D US decreases acquisition time compared to standard 2D US protocols, without deteriorating the diagnostic quality (Kim et al 2018).…”

Can 3-dimensional cranial ultrasound be used to successfully reconstruct a 2-dimensional image without compromising on image quality in a neonatal population?

“…Three-D US has been shown to produce diagnostic images in multiple radiology subspecialities, ranging from breast to obstetrics, and inclusive of both the fetal and neonatal brain [ 6 – 9 , 9 , 10 ]. Irrespective of the method used, 3-D US acquisition is semi-automated, with reduced input from the operator [ 11 ].…”

“…Additionally, 3-D US allows the acquisition of a volumetric data set of the whole area of interest, reducing the potential to miss relevant anatomical regions, and increasing intra- and inter-individual reproducibility through permitting reconstruction in multiple planes [ 12 ]. Shorter acquisition times have also been shown for acquiring 3-D studies [ 8 , 9 ], which is of clear benefit to sick neonates immobilised by medical equipment. Therefore, 3-D US offers multiple solutions to many of the limitations of 2-D US.…”

“…The ability of 3-D US to depict certain intracranial pathologies in the neonatal population has been demonstrated to be similar to 2-D US, with potential advantages such as more accurate volume measurements [ 8 , 9 ]. However, it is not feasible to compare every possible intracranial pathology and the ability to identify normal anatomical landmarks is a good surrogate, as many pathologies manifest as alterations to these structures.…”

Quantitative 3-D head ultrasound measurements of ventricle volume to determine thresholds for preterm neonates requiring interventional therapies following posthemorrhagic ventricle dilatation

“…Previous work with transfontanelle brain three-dimensional (3-D) US has been attempted in neonates 9 – 13 While this imaging technique was shown to be feasible and gives similar measurements 14 and diagnosis 12 , 15 , 16 as two-dimensional (2-D) US, its clinical utility beyond 2-D has not been established. Recent studies have had success acquiring 3-D US images of neonatal ventricles using commercial systems; 9 , 10 , 12 , 14 – 16 however, these transducers are not part of standard-of-care and must be purchased separately.…”