Microvascular Ultrasound Imaging in the Neonatal Brain: From Advanced Doppler to Super-Resolution

In imaging the neonatal brain, overcoming the diffraction limit of conventional ultrasound is required to achieve images of sufficient spatial resolution. Super-resolution imaging uses ultrasound localization microscopy to image inert microbubble contrast at high frame rates, allowing exquisite detail and flow information on intracranial vessels. While currently more common in research settings, super-resolution imaging is beginning to see selective clinical use. In contrast, advanced Doppler techniques, which do not require contrast, offer flow imaging far better than that of conventional Doppler and are readily available in the clinical setting. We discuss the pros and cons of both modalities and the promising applications of both in the clinical setting with a series of case examples.