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Published on: February 2, 2015
Assessment of skeletal development in preterm and term infants by quantitative ultrasound
Ewald Ritschl1, Kristel Wehmeijer, Francesca DE Terlizzi
1Universitätsklinik für Kinder und Jugendheilkunde, A-8036-Graz, Austria. ewald.ritschl@klinikum-graz.at
Insights
Quantitative ultrasound (QUS) safely assesses skeletal development in preterm infants. Metacarpal bone transmission time (mcBTT) measurements offer insights into bone tissue, independent of infant size.
Area of Science:
- Pediatric Bone Health
- Medical Imaging
- Neonatology
Background:
- Assessing skeletal development in critically ill preterm infants requires nonionizing methods.
- Quantitative ultrasound (QUS) is a potential nonionizing technique for evaluating bone health.
Purpose of the Study:
- To investigate the utility of QUS for assessing skeletal development and maturation in preterm infants.
- To establish reference curves for metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) in infants.
Main Methods:
- Cross-sectional and longitudinal data collection in preterm and term infants.
- Measurement of metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) using QUS.
- Development of reference curves for mcSOS and mcBTT.
Main Results:
- Both mcSOS and mcBTT increase during the third trimester of gestation.
- mcSOS declines post-birth up to 6 months, then increases; mcBTT remains stable initially.
- Preterm infants exhibit lower QUS values at birth compared to term infants, with mcBTT increasing to term infant levels over time.
- mcBTT values in preterm infants appear independent of length and weight.
Conclusions:
- QUS is a safe, repeatable, and reliable method for monitoring skeletal development in preterm infants.
- mcBTT provides valuable information on bone tissue maturation in preterm infants, independent of anthropometric measures.
- QUS can effectively track skeletal maturation in preterm neonates.
Abstract:
Assessment of skeletal development using a nonionizing method would be desirable in critically ill preterm infants. We investigated the second metacarpus by quantitative ultrasound (QUS). Cross-sectional data were collected in 132 preterm or term infants measured within 24 h from birth and in 142 term infants up to the age of 18 mo. Longitudinal data were collected in 150 preterm infants up to the age of 14 mo. Cross-sectional data were used to devise reference curves for metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT). Both parameters increase during the last trimester of gestation. After birth, mcSOS declines up to the 6 mo and then increases up to 18 mo of life. McBTT values remain stable after birth. At birth, QUS values of preterm infants are lower than those observed at birth in term infants. In the longitudinal study, mcSOS showed a trend similar to that observed among term infants, nevertheless, values are lower up to 4-6 mo of life. Among preterm infants, mcBTT increases until it reaches values observed in term infants. Preterm infants in their first months of life have lower QUS values compared with term infants of same weight or length. This study demonstrates that it is possible to follow skeletal development and maturation by QUS in preterm infants. More specifically, the mcBTT values may provide information on bone tissue that is independent of length and weight of the preterm infant. The method here described is safe, repeatable, and reliable.
