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[Quantitative ultrasound for the assessment of bone in the preterm infant]
F Bagnoli1, M S Toti, M L Conte
1Unità Operativa Complessa di Terapia Intensiva Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della RiproduzioneAzienda Ospedaliera Universitaria di Siena, Siena, Italia. bagnoli@unisi.it
Insights
Quantitative ultrasound effectively assesses bone health in preterm infants, identifying subtle differences related to size and gestational age. This non-invasive method aids in early detection and monitoring of bone status in newborns.
Area of Science:
- Neonatology
- Pediatric Orthopedics
- Medical Imaging
Background:
- Preterm infants face risks of osteopathy of prematurity (OP).
- Accurate assessment of bone mineral status is crucial for critically ill preterm infants.
- Current methods may be invasive or less suitable for this population.
Purpose of the Study:
- To evaluate quantitative ultrasound (QUS) as a safe, non-invasive tool for assessing bone mineral status in preterm infants.
- To determine the correlation between QUS parameters and infant biometrics.
- To explore QUS's utility in identifying infants at risk for bone abnormalities.
Main Methods:
- Sixty preterm infants (gestational age 22-36 weeks) were assessed in a Neonatal Intensive Care Unit.
- Quantitative ultrasound measurements (bone transmission time - BTT, speed of sound - SOS) were taken on the second metacarpus.
- Data were analyzed for correlations with gestational age, birth weight, and birth length.
Main Results:
- BTT showed strong positive correlations with birth gestational age, birth weight, and birth length (P<0.001).
- SOS also correlated significantly with gestational age, birth weight, and birth length (P<0.05).
- Infants small for gestational age exhibited lower BTT values compared to appropriate-sized infants (P<0.03).
Conclusions:
- Quantitative ultrasound is a safe, easy-to-perform, and non-invasive method for evaluating bone mineral status in preterm infants.
- QUS can detect subtle differences in bone status related to gestational age, weight, and length.
- This technique serves as a valuable screening tool for early bone status detection and longitudinal assessment in newborns and growing children.
Aim:
Preterm infants are at risk of osteopathy of prematurity (OP). The present study aims to assess quantitative ultrasound as a safe and non-invasive method in evaluating bone mineral status in the critically ill preterm infant.
Methods:
Sixty preterm infants (27 females) have been evaluated in the Neonatal Intensive Care Unit of the University Hospital of Siena. Gestational age was between 22 and 36 weeks and birth weight ranged between 610 and 3240 g. A single operator did all the measurements on the second metacarpus by the DBM Sonic BP (IGEA). Ultrasound parameters were bone transmission time (BTT, micros) and speed of sound (SOS, m/s).
Results:
BTT positively increased with birth gestational age (r=0.72, P<0.001, F-Ratio=62.4428), birth weight (r=0.7827, P<0.001, F-Ratio=91.7274) and birth length (r=0.7729, P<0.001, F-Ratio=86.0748). SOS was also related with gestational age (r=0.2937, P<0.023, F-Ratio=5.4768), birth weight (r=0.2634, P<0.042, F-Ratio=4.3250) and birth length (r=0.3252, P<0.011, F-Ratio=6.8596). Small infants for gestational age showed BTT values lower then infants with appropriate size for gestational age (P<0.03). There was no difference between male and female infants.
Conclusion:
Quantitative ultrasound is a non-invasive method, which is easy to perform in a Neonatal Intensive Unit, safe, harmless and gentle. This method detects subtle differences in bone mineral status, according to gestational age, weight and length. Quantitative ultrasound is a useful screening tool for early detection of bone status in newborns and a valid method for the longitudinal assessment of bone in growing children.
