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[Echoencephalography in premature infants. Normal values and limitations]
Insights
This study measured brain ventricle width in premature infants. While the third ventricle appeared normal, the brain mantle index yielded unreliable results, possibly due to technical challenges.
Area of Science:
- Neonatal Neurology
- Pediatric Imaging
- Neurodevelopmental Pediatrics
Context:
- Premature infants (birth weight < 2500g) pose unique challenges in neurodevelopmental assessment.
- Early neuroimaging is crucial for identifying potential neurological complications in this vulnerable population.
- Standardized measurement techniques are essential for reliable interpretation of pediatric neuroimaging.
Purpose:
- To evaluate the width of the third ventricle and the brain mantle index in premature infants post-weight gain.
- To assess the correlation between these measurements and birth weight or gestational age.
- To identify potential technical limitations in echoencephalography for neonatal brain assessment.
Summary:
- A cohort of 125 premature infants underwent echoencephalography upon reaching 2500g birth weight.
- The third ventricle width was consistently normal (2-3 mm), independent of birth weight and gestational age, with only two infants showing elevated values.
- The brain mantle index produced highly variable and unsatisfactory results (2.35-4.91), significantly exceeding normal adult values, suggesting methodological issues.
Impact:
- Establishes normative data for third ventricle width in a specific premature infant cohort.
- Highlights significant technical challenges and inaccuracies in calculating the brain mantle index using echoencephalography in neonates.
- Suggests a need for refinement of imaging techniques or alternative methods for assessing brain mantle development in premature infants.
Abstract:
The study includes a continuous and unselected group of 125 premature infants whose birth weight was below 2500 gr. The echo-encephalogram was done at the time when the infants had reached a weight of 2500 gr. The width of the third ventricle and the brain mantle index (relation between the distances of midline echo-end echo and echo of the lateral wall of the temporal horn-end echo) were measured. The third ventricle showed a normal width of 2--3 mm which was independant from birth weight and gestational age. There were only two infants with higher values, one of them had different symptoms of brain damage. The calculation of the brain mantle index showed unsatisfactory results. The values varied between 2,35 and 4,91. They were markedly beyond the normal value of 2,4 of adults and bigger children. Technical difficulties in temporal horn and inaccuracy in reading the results on the screen as a possible cause of these discrepancies are disussed.