Related Experiment Videos
Cranial ultrasound in preterm infants: long term follow up
Insights
Cranial ultrasound follow-up for high-risk preterm infants is recommended until 2-3 months. Most infants with normal neonatal scans had normal 1-year scans, indicating limited need for extended follow-up.
Area of Science:
- Neonatal Neurology
- Pediatric Radiology
- Medical Imaging
Background:
- High-risk preterm infants often experience neurological complications.
- Cranial ultrasound is a key diagnostic tool for monitoring these infants.
- Understanding the natural progression of findings is crucial for optimizing follow-up protocols.
Purpose of the Study:
- To evaluate the changes in cranial ultrasound findings in high-risk preterm infants from the neonatal period to 1 year of age.
- To determine the optimal duration for cranial ultrasound follow-up in this population.
- To correlate neonatal ultrasound findings with later neurodevelopmental outcomes.
Main Methods:
- A cohort of 129 high-risk preterm infants (26-36 weeks gestational age) underwent serial cranial ultrasounds.
- Neonatal scans were performed using an ATL Mk III echoscope, with 1-year follow-up using an Octoson scanner.
- Data analysis focused on the incidence and evolution of cerebroventricular hemorrhages, other lesions, and ventricular changes.
Main Results:
- Abnormal neonatal scans were observed in 66 infants, with 53 showing cerebroventricular hemorrhages.
- Post-hemorrhagic changes developed in 30 infants.
- At 1 year, 27 children had abnormal scans, primarily ventricular dilatations; however, 60% of those with abnormal neonatal scans normalized by 1 year.
Conclusions:
- Cranial ultrasound findings in high-risk preterm infants stabilize by 2-3 months of age.
- Extended follow-up beyond 2-3 months is rarely necessary for this cohort.
- Serial cranial ultrasound monitoring can be tailored to optimize resource utilization while ensuring timely detection of significant abnormalities.
Abstract:
One hundred and twenty nine high risk preterm infants (gestational ages 26-36 weeks, mean 31.2 weeks; birth weights 800-3880 g, mean 1490 g) were studied by cranial ultrasound during the neonatal period, over a period of one week to three months, and at the age of 1 year. Neonatal ultrasound scanning was performed with an ATL Mk III real time echoscope, and follow up ultrasound scans at the age of 1 were performed with an Octoson static compound scanner. The neonatal scans of 66 infants were abnormal. Cerebroventricular haemorrhages were detected in 53 infants and other lesions in 19, six of whom also had haemorrhages. Posthaemorrhagic changes developed in 30 infants. The follow up scans at 1 year were abnormal in 27 children. One large parenchymal cyst was detected. All 27 scans showed ventricular dilatations; 19 were asymmetrical. About 95% of the children with normal neonatal scans and 60% with abnormal neonatal scans had normal scans at 1 year. The size and shape of the ventricular system had changed in 20% of all infants. As no major changes were seen in the ultrasound images of those studied beyond the age of 2 months cranial ultrasound follow up in high risk preterm infants should therefore be continued until the age of 2-3 months; follow up beyond that age would only rarely be necessary.