Quantitative 3-D head ultrasound measurements of ventricle volume to determine thresholds for preterm neonates requiring interventional therapies following posthemorrhagic ventricle dilatation

• Published in: Journal of medical imaging (Bellingham, Wash.) Vol. 5; no. 2; p. 026001
• Main Authors: Kishimoto, Jessica, Fenster, Aaron, Lee, David S. C, de Ribaupierre, Sandrine
• Format: Journal Article
• Language: English
• Published: United States Society of Photo-Optical Instrumentation Engineers 01.04.2018
• Subjects: Biomedical Applications in Molecular, Structural, and Functional Imaging; preterm neonate; hydrocephalus; neurosurgery; cranial ultrasound; three-dimensional ultrasound
• ISSN: 2329-4302; 2329-4310
• DOI: 10.1117/1.JMI.5.2.026001

Dilatation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage. This posthemorrhagic ventricle dilatation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure, and without treatment can lead to death. Two-dimensional ultrasound (US) through the fontanelles of the patients is serially acquired to monitor the progression of PHVD. These images are used in conjunction with clinical experience and physical exams to determine when interventional therapies such as needle aspiration of the built up cerebrospinal fluid (ventricle tap, VT) might be indicated for a patient; however, quantitative measurements of the ventricles size are often not performed. We describe the potential utility of the quantitative three-dimensional (3-D) US measurements of ventricle volumes (VVs) in 38 preterm neonates to monitor and manage PHVD. Specifically, we determined 3-D US VV thresholds for patients who received VT in comparison to patients with PHVD who resolve without intervention. In addition, since many patients who have an initial VT will receive subsequent interventions, we determined which PHVD patients will receive additional VT after the initial one has been performed.