Evaluation of neonatal cerebral perfusion using three‐dimensional power Doppler ultrasound volumes

Abstract

Aim Despite improvement in preterm survival, neurological morbidity remains high. 3D fractional moving blood volume (3D‐FMBV) quantifies neonatal cerebral perfusion by calculating a standardised measure of the amount of moving blood in a region of interest and correlates with tissue perfusion in animal studies. However, its feasibility and reproducibility are yet to be assessed in newborn infants. Methods Fractional moving blood volume analysis was performed on three‐dimensional power Doppler ultrasound (PD‐US) volumes from a cohort of preterm infants recruited in 2015 from the Royal Hospital for Women Neonatal Intensive Care Unit. The volumes were acquired by two sonographers and analysed by two different observers. The 3D‐FMBV algorithm was applied to calculate an estimate for perfusion. Reproducibility and agreement were assessed using intra‐class correlation coefficients (ICC) and Bland‐Altman plots. Results All 3D PD‐US volumes were analysed successfully. Intra‐observer reliability was excellent with an ICC of 0.907 (95% CI 0.751–0.968) and 0.906 (95% CI 0.741–0.967) for two independent observers respectively. The inter‐observer reliability of the entire technique was good with an ICC of 0.752 (CI: 0.404–0.909). Conclusion We have successfully shown the feasibility and reliability of applying the 3D‐FMBV technique to the neonatal brain in a healthy preterm population.

Neurosonography: Shaping the future of neuroprotection strategies in extremely preterm infants

“…The study successfully demonstrated the feasibility and reliability of using 3D-FMBV technology to measure cerebral perfusion in a healthy preterm infant population. This technology can perform a correlational analysis with standardized quantification standards by calculating the perfusion of flowing blood in the region of interest, thereby judging the perfusion situation [ 42 ].…”