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Updated: Feb 16, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Three-dimensional ultrasound cranial imaging and early neurodevelopment in preterm growth-restricted infants
Glenda McLean1, Catherine Hough2, Arvind Sehgal3,4
1Department of Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia.
Insights
Fetal growth restriction (FGR) in preterm infants is linked to poorer motor skills, detectable by the Test of Infant Motor Performance (TIMP). Early 3D ultrasound may help identify neuropathology that contributes to these functional deficits.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Fetal Medicine
Background:
- Fetal growth restriction (FGR) is a significant risk factor for adverse perinatal outcomes and long-term neurodevelopmental issues.
- Early identification of neurodevelopmental deficits in preterm infants with FGR is crucial for timely intervention.
Purpose of the Study:
- To investigate early neurodevelopmental deficits in preterm infants with FGR using 3D head ultrasound and developmental assessments.
- To compare these findings with appropriate for gestational age (AGA) preterm infants.
Main Methods:
- A cohort of 20 preterm FGR infants (<10th percentile) and age-matched AGA infants (28-32 weeks gestation) were studied.
- Three-dimensional ultrasound assessed cerebral ventricular volumes in the second postnatal week.
- Prechtl General Movement Assessments and the Test of Infant Motor Performance (TIMP) evaluated motor development at 4-6 and 12-14 weeks corrected age.
Main Results:
- No significant difference in combined cerebral ventricular volume was found between FGR and AGA groups.
- FGR infants showed a trend towards lower TIMP scores at 12-14 weeks corrected age, indicating worse functional motor performance.
- A significant negative correlation was observed between greater ventricular volume and lower TIMP scores across both groups.
Conclusions:
- Early 3D head ultrasound may detect neuropathology in preterm FGR infants.
- This neuropathology could underlie the observed functional motor deficits, as suggested by TIMP scores.
- These findings highlight the potential of early neuroimaging and functional assessments for managing FGR-related neurodevelopmental risks.
Aim:
Fetal growth restriction (FGR) is associated with increased perinatal morbidity, mortality and long-term neurodevelopmental sequelae. The objective of this study was to examine whether information about early neurodevelopmental deficits was evident using three-dimensional head ultrasound and developmental assessments in preterm infants with FGR, compared with appropriate for gestational age (AGA) infants in the early post-natal period.
Methods:
Twenty preterm FGR infants weighing <10th centile and born between 28 and 32 weeks were compared with age-matched AGA infants. In the second post-natal week after birth, we used three-dimensional ultrasound to assess cerebral ventricular volumes. Prechtl General Movement Assessments were performed at 4-6 weeks after birth. Test of Infant Motor Performance (TIMP) to measure functional motor behaviour was performed at 4-6 and 12-14 weeks corrected age.
Results:
There was no statistically significant difference in the combined cerebral ventricular volume between the two groups (FGR, 0.81 ± 0.42 vs. AGA 0.72 ± 0.38 cm3 , P = 0.4). The TIMP assessment at 12-14 week term corrected demonstrated lower scores (worse performance) in FGR infants compared with the AGA cohort (regression coefficient: -7.74 (95% CI -16.06, 0.57); P = 0.07). We observed a significant correlation between greater ventricular volume and lower TIMP scores in the cohorts separately and also overall (FGR, r = -0.5, P = 0.06 vs. AGA, r = -0.62, P = 0.007 and overall, r = -0.53, P = 0.001).
Conclusion:
Ultrasound in the early weeks may be useful to detect the neuropathology which could then mediate functional consequences.
