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Relationship between biparietal diameter/ventricular ratio and neurodevelopmental outcomes in non-handicapped very
Şehribanu Işık1, Mehmet Büyüktiryaki2, Gülsüm Kadıoğlu Şimşek2
1Department of Neonatology, NICU, University of Health Sciences, Ankara City Hospital MH5, Çankaya, 06800, Ankara, Turkey. sbanuozluer@hotmail.com.
Insights
A reduced biparietal diameter to ventricle ratio in preterm infants, measured by cranial ultrasonography, is linked to poorer neurodevelopmental outcomes. This ratio aids in assessing brain development in very low birth weight infants.
Area of Science:
- Neonatal neuroimaging
- Pediatric neurology
- Developmental pediatrics
Background:
- Preterm infants face significant risks of brain damage and long-term neurodevelopmental issues.
- Cranial ultrasonography is the primary neuroimaging tool for very low birth weight (VLBW) infants.
- Ventricle size and its proportion to brain volume are crucial indicators of central nervous system status in preterm neonates.
Purpose of the Study:
- To calculate the biparietal diameter/ventricular ratio in preterm infants using cranial ultrasonography.
- To evaluate the association between this ratio and neurodevelopmental outcomes at 24 months corrected age.
Main Methods:
- Cranial measurements, including biparietal diameter (BPD) for total brain volume and ventricular index (VI) and thalamo-occipital distance (TOD) for ventricle size, were obtained via routine ultrasonography.
- The BPD/(VI+TOD) ratio was calculated as a measure of brain tissue proportion.
- Neurodevelopmental assessment included Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores.
Main Results:
- Data from 482 preterm infants (mean gestational age 27.6 weeks, mean birth weight 1010 g) were analyzed.
- The mean BPD/(VI+TOD) ratio was 32.90 (±2.32).
- Significantly lower MDI and PDI scores were observed in patients with a reduced BPD/(VI+TOD) ratio compared to those without (p < 0.001 for all).
Conclusions:
- The BPD/ventricle ratio can be reliably calculated using 2D ultrasound measurements in VLBW infants.
- A reduced BPD/ventricle ratio is significantly associated with adverse neurodevelopmental outcomes in preterm infants.
Purpose:
Preterm infants are at high risk for brain damage and long-term neurodevelopmental problems. Cranial ultrasonography is the main neuroimaging technique for very low birth weight infants. Ventricle size and its ratio to brain volume contribute very important information about the central nervous system of preterm babies. We calculated biparietal diameter/ventricular ratio of preterm infants using cranial ultrasonography and evaluate the relationship between this ratio and neurodevelopment.
Methods:
Cranial measurements were derived using routine ultrasonographic scanning. Transverse brain length, or biparietal diameter (BPD), was considered a representation of the total brain, ventricular index (VI) and thalamo-occipital distance (TOD) length were used to represent the ventricles, and their ratio was accepted as a measure of the tissue portion of the brain. The ratio of BPD to the sum of left and right VI and TOD values was recorded as BPD/(VI+TOD) ratio.
Results:
Data from a total of 482 patients were analyzed. The mean gestational age was 27.6 (24-29.6) weeks and the mean birth weight was 1010 (350-1390) g. The mean BPD/(VI+TOD) ratio was 32.90 (± 2.32). At 24 months corrected age, the patients' mean MDI score was 78.64 (± 13.29) and mean PDI score was 79.49 (± 14.31). When patients with and without NDI were compared, there were significant differences between the groups in terms of BPD/(VI+TOD) ratio, MDI, and PDI (p < 0.001, p < 0.001, p < 0.001, respectively).
Conclusion:
The BPD/ventricle ratio can be calculated using two-dimensional measurements in VLBW infants and reduced BPD/ventricle ratio was associated with poor neurodevelopmental outcomes.
Trial Registration:
NCT02848755.
