Assessment of Cerebral Microvascular Development in Preterm Neonates Using Ultrafast Power Doppler Imaging

Area of Science:

• Neonatal Neurology
• Medical Imaging
• Vascular Biology

Background:

• Preterm birth affects over 10% of global births, leading to high disability and mortality due to incomplete development.
• Cerebral microvascular development in neonates of varying gestational ages (GAs) is not well understood but is crucial for brain development.
• Ultrafast power Doppler imaging offers a novel approach to assess neonatal cerebral vasculature.

Purpose of the Study:

• To assess cerebral microvascular development in preterm neonates with different gestational ages (GAs).
• To evaluate quantitative microvascular metrics and their correlation with GA and brain activity.

Main Methods:

• Seventy neonates (7 full-term, 63 preterm) were studied using ultrafast power Doppler imaging.
• Quantitative metrics, including microvascular area (MArea) and microvascular diameter (MDiam), were measured in three specific brain regions.
• Brain activity was assessed using amplitude-integrated electroencephalography (aEEG), and correlations with microvascular metrics and GA were analyzed.

Main Results:

• All microvascular quantitative metrics showed a statistically significant positive correlation with gestational age (GA) and aEEG (p < 0.05).
• Microvascular area (MArea) in the cingulate gyrus (ROI 1) exhibited the strongest correlation with GA (coefficient = 0.67, p < 0.0001).
• MArea in ROI 1 also showed a high correlation with aEEG (coefficient = 0.53, p < 0.0001).

Conclusions:

• Parameters related to microvascular area (MArea) and diameter (MDiam) are associated with increasing gestational age in preterm neonates.
• Findings suggest a trend toward cerebral microvascular maturation with advancing GA in preterm infants.
• This study highlights the utility of ultrafast power Doppler imaging in evaluating neonatal brain development.