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Updated: Feb 6, 2026

State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Features of serial cranial ultrasound detected neuropathology in very preterm infants
A Petrova1, M Karatas2, R Mehta1
1Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Insights
Changes in cranial ultrasound findings in very preterm infants are linked to neonatal conditions. Initial findings and morbidities help predict brain lesions by one month of age, aiding clinical management.
Area of Science:
- Neonatal neurology
- Pediatric imaging
- Perinatal medicine
Background:
- Cranial ultrasound (CUS) is crucial for monitoring brain development in preterm infants.
- Understanding changes in CUS findings is essential for managing very preterm neonates.
Purpose of the Study:
- To identify patterns and factors associated with changes in cranial ultrasound findings.
- To analyze alterations in CUS detected findings in infants born at or before 28 weeks of gestation.
Main Methods:
- Comparison of CUS readings from the first week and 4-5 weeks of life.
- Classification of CUS findings as unchanged, worsening, or improved.
- Statistical analysis including logistic regression and kappa statistics.
Main Results:
- 82.3% of infants had unchanged CUS findings, 10.0% showed worsening, and 7.7% improved.
- Moderate agreement (k=0.62) was observed between initial and later CUS scans.
- Worsening CUS findings correlated with neonatal morbidities, particularly with initial intraventricular hemorrhage (IVH) grades.
Conclusions:
- Initial CUS findings and neonatal morbidities predict brain lesions in very preterm infants by one month.
- This predictive capability can inform clinical management strategies for these vulnerable infants.
Background:
The purpose of this study was to identify the pattern and factors associated with changes in cranial ultrasound (CUS) -detected findings in infants born at or less than 28 weeks of gestation.
Methods:
We compared readings of CUS performed at the end of the first week of life and at 4-5 weeks of age. Alteration of CUS findings was classified as: (i) unchanged, if no deviation was detected (Group 1); (ii) worsening, if there were new findings (Group 2); and (iii) improvement, if there was normalization or reduction in severity (Group 3). Descriptive statistics, multivariate controlled logistic regression, and kappa (k) statistics with 95% Confidence Interval (95% CI) were reported.
Results:
Among 510 studied infants, 82.3% (95% CI 78.8-85.4) were in Group 1, 10.0% (95% CI 7.7-12.9) in Group 2, and 7.7% (95% CI 5.7-10.3) in Group 3. Overall agreement between the two scans was moderate (k 0.62; 95% CI 0.55-0.69). Worsening of CUS findings was associated with neonatal morbidities independently from gestational age and birth weight. The probability for worsening of CUS findings was higher in infants with an initial diagnosis of intraventricular hemorrhage (IVH) grade 2, than in those reported as no pathology/IVH grade 1 (Odds Ratio 5.79; 95% CI 2.42-13.91) or IVH grade 3-4 (Odds Ratio 3.81; 95% CI 1.10-13.21).
Conclusions:
In very preterm born infants, the initial CUS findings in combination with neonatal morbidities can help predict the brain lesions that are seen at the end of the first month of life and could be useful in their clinical management.
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