Ultrasound measurements of the lateral ventricles in neonates: why, how and when? A systematic review

Abstract

Serial cranial ultrasound measurements of the lateral ventricles play a key role in the early recognition and therapeutic evaluation of post-haemorrhagic ventricular dilation and can be of prognostic value in neonates with ventricular dilatation.

New Reference Values for the Neonatal Cerebral Ventricles

“…Recently, we reviewed available data on this topic and demonstrated considerable variation among reported reference curves, especially for the most immature infants, who face the greatest risk of developing ventricular dilation ( 11 ). A substantial number of studies were conducted more than a decade ago with less-sophisticated US equipment.…”

Preterm neuroimaging and neurodevelopmental outcome: a focus on intraventricular hemorrhage, post-hemorrhagic hydrocephalus, and associated brain injury

“…Both high grade IVH and white matter injury increase risk for later ventriculomegaly and poor brain growth [32, 34–36]. Following IVH, HUS is more reliable to detect ventriculomegaly than clinical assessments of fontanelle exam or serial head circumferences [37].…”

“…Measurements for the ventricular index (VI), anterior horn width (AHW), and thalamooccipital distance (TOD) have been published and are detailed in Table 3 [10–15, 34]. Intra- and interobserver agreement for degree of ventriculomegaly and these measurements is good across studies [46–48].…”

Preterm neonatal lateral ventricle volume from three-dimensional ultrasound is not strongly correlated to two-dimensional ultrasound measurements

“…This is further confounded by the user-dependent nature of 2-D US as the technician only records some image planes, furthermore, there has been no consensus on what should be measured by a radiologist to best illustrate VV. 6 The "gold standard" to quantify VV makes use of threedimensional (3-D) MR images, but can only be acquired once the patient is stable enough to be transferred to the imaging suite -often weeks after initial diagnosis and intervention for PHVD. Indeed, only a few studies directly comparing 2-D US and MRI measurements of the ventricles have been done.…”

“…However, studying neonates born <30 weeks GA and comparing VI, AHW, and TOD near birth to that at term equivalent age (GA 37 to 40 weeks), the authors found increases over time for all US measurements. 23 Recent studies 6,24 have advised using the >97th percentile of 2-D US measurements as the "action line" for when interventional therapies should begin. While this may provide guidance as to when the first intervention should occur, often patients with severe PHVD will remain over the 97th percentile even after intervention.…”