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Updated: May 8, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Preterm cerebellum at term age: ultrasound measurements are not different from infants born at term
André M Graça1, Ana Filipa Geraldo2, Katia Cardoso1
1Departmento de Pediatria, Serviço de Neonatologia, Hospital de Santa Maria/Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
Insights
Preterm infants show preserved cerebellar growth at term-equivalent age, measurable by cerebral ultrasound (cUS). This imaging tool can identify infants at higher risk for developmental issues.
Area of Science:
- Neonatal neuroimaging
- Pediatric neurology
- Developmental pediatrics
Background:
- Preterm infants often exhibit reduced supratentorial brain growth.
- Cerebellar growth may be preserved, particularly without supratentorial injury.
Purpose of the Study:
- Compare cerebellar size in preterm infants versus term-born controls at term-equivalent age (TEA).
- Evaluate the utility of cerebral ultrasound (cUS) for assessing cerebellar growth in preterm neonates.
Main Methods:
- Cerebellar dimensions (TCD, vermis height, APVD, CVA) measured via cUS in 71 preterm infants (<32-wk gestation) and 58 controls at TEA.
- Image Arena software used for measurements; intra- and interobserver agreement assessed.
Main Results:
- Preterm infants had smaller transverse cerebellar diameters (TCD) but larger cerebellar vermis areas (CVA) and anteroposterior vermis diameters (APVD) compared to controls.
- Differences in cerebellar dimensions were not significant after adjusting for head shape.
- Cerebellar vermis area (CVA) was similar in the most immature preterm infants (<28-wk gestation) and small-for-gestational-age infants compared to controls.
Conclusions:
- Neonatal cerebellar growth sparing is supported in preterm infants, detectable by cUS.
- cUS is a viable tool for assessing cerebellar size at TEA, considering both width and height.
- This method can help identify preterm infants with poorer cerebellar growth at risk for disability.
Background:
Reduced supratentorial brain growth has been shown in preterm-born infants at term-equivalent age (TEA), but cerebellar growth may be preserved in the absence of supratentorial injury. Our study aims to compare cerebellar size assessed using cerebral ultrasound (cUS) at TEA between preterm infants and term-born controls.
Methods:
Cerebellar dimensions (including transverse cerebellar diameter (TCD), cerebellar vermis height, anteroposterior vermis diameter (APVD), and cerebellar vermis area (CVA)) were measured using Image Arena software (TomTec Imaging Systems, Unterschleissheim, Germany) in 71 infants <32-wk gestation without significant scan abnormality at TEA and in 58 term-born control infants. Intra- and interobserver agreement were evaluated.
Results:
In comparison with controls, preterms at TEA had smaller TCDs (4.9 vs. 5.2 cm; P < 0.001) but larger CVAs (4.7 vs. 4.3 cm(2); P < 0.005) and APVDs (2.4 vs. 2.2 cm; P < 0.001); however, these differences were no longer seen after accounting for head shape. In <28-wk gestational age infants, CVA was statistically similar to controls, as were for small-for-gestational-age infants.
Conclusion:
Our data support neonatal sparing of preterm cerebellar growth that is measureable using cUS, and this includes the most immature and small-for-gestational-age infants. We suggest cUS can be used to assess cerebellar size at TEA, with measures of both width and height being taken into account, and thus may be a useful tool for detecting infants with poorer cerebellar growth who are at increased risk of disability.
