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CC BY-NC-ND 4.0 · Ultrasound Int Open 2022; 08(02): E43-E52
DOI: 10.1055/a-1958-3985
Original Article

Quantitative Evaluation of Brain Echogenicity in Hypoxic-Ischemic Encephalopathy in Term Neonates Compared with Controls

Fabrício Guimarães Gonçalves
1   Radiology, The Children’s Hospital of Philadelphia, Philadelphia, United States
,
Colbey Freeman
2   Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States
,
Dmitry Khrichenko
1   Radiology, The Children’s Hospital of Philadelphia, Philadelphia, United States
,
Misun Hwang
1   Radiology, The Children’s Hospital of Philadelphia, Philadelphia, United States
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Abstract

Purpose Neurosonography evaluation of neonatal hypoxic-ischemic encephalopathy (HIE) is mainly qualitative. We aimed to quantitatively compare the echogenicity of several brain regions in patients with HIE to healthy controls.

Materials and Methods 20 term neonates with clinical/MRI evidence of HIE and 20 term healthy neonates were evaluated. Seven brain regions were assessed [frontal, parietal, occipital, and perirolandic white matter (WM), caudate nucleus head, lentiform nucleus, and thalamus]. The echogenicity of the calvarial bones (bone) and the choroid plexus (CP) was used for ratio calculation. Differences in the ratios were determined between neonates with HIE and controls.

Results Ratios were significantly higher for HIE neonates in each region (p<0.05). The differences were greatest for the perirolandic WM, with CP and bone ratios being 0.23 and 0.22 greater, respectively, for the HIE compared to the healthy neonates (p<0.001). The perirolandic WM had a high AUC, at 0.980 for both the CP and bone ratios. The intra-observer reliability for all ratios was high, with the caudate to bone ratio being the lowest at 0.832 and the anterior WM to CP ratio being the highest at 0.992.

Conclusion When coupled with internal controls, quantitative neurosonography represents a potential tool to identify early neonatal HIE changes. Larger cohort studies could reveal whether a quantitative approach can discern between degrees of severity of HIE. Future neurosonography protocols should be tailored to evaluate the perirolandic region, which requires posterior coronal scanning.

Key words

brain - areas - structures & systems - ultrasound - methods & techniques - hypoxia - themes


Publication History

Received: 10 April 2021

Accepted after revision: 07 August 2022

Article published online:
16 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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