Abstract
BACKGROUND
To compare the ability of ventricular morphology on cranial ultrasound (CUS) versus standard clinical variables to predict the need for temporizing cerebrospinal fluid drainage in newborns with intraventricular hemorrhage (IVH).
Method
This is a retrospective study of newborns (gestational age <29 weeks) diagnosed with IVH. Clinical variables known to increase the risk for post-hemorrhagic hydrocephalus were collected. The first CUS with IVH was identified and a slice in the coronal plane was selected. The frontal horns of the lateral ventricles were manually segmented. Automated quantitative morphological features were extracted from both lateral ventricles. Predictive models of the need of temporizing intervention were compared.
Results
Sixty-two newborns met inclusion criteria. Fifteen out of the 62 had a temporizing intervention. The morphological features had a better accuracy predicting temporizing interventions when compared to clinical variables: 0.94 versus 0.85, respectively; p < 0.01 for both. By considering both morphological and clinical variables, our method predicts the need of temporizing intervention with positive and negative predictive values of 0.83 and 1, respectively, and accuracy of 0.97.
Conclusion
Early cranial ultrasound-based quantitative ventricular evaluation in premature newborns can predict the eventual use of a temporizing intervention to treat post-hemorrhagic hydrocephalus. This may be helpful for early monitoring and treatment.
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Acknowledgments
Thank you to Dr. Joseph Piatt MD from the Department of Neurosurgery at Nemours/A. I. DuPont Hospital for Children for his review of this manuscript and his valuable remarks.
Author contributions
R.O. conceptualized and designed the study, acquired the data, performed the technical analysis of the ultrasound images, and drafted the reviewed the manuscript. P.R.T. conceptualized and designed the study, acquired the data, performed the technical analysis of the ultrasound images, and drafted and reviewed the manuscript. She also performed the statistical analysis. M.G.L. helped conceptualizing and designing the study and critically reviewing the manuscript for important intellectual content and final approval of the version to be published. A.A.P. helped conceptualizing and designing the study and critically reviewing the manuscript for important intellectual content and final approval of the version to be published. J.J.C. helped conceptualizing and designing the study and reviewed the manuscript. A.M. helped conceptualizing and designing the study and critically reviewing the manuscript for important intellectual content and final approval of the version to be published. T.C. helped drafting the article and revising it critically for important intellectual content and final approval of the version to be published.
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Obeid, R., Tabrizi, P.R., Mansoor, A. et al. Ventricular shape evaluation on early ultrasound predicts post-hemorrhagic hydrocephalus. Pediatr Res 85, 293–298 (2019). https://doi.org/10.1038/s41390-018-0252-0
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DOI: https://doi.org/10.1038/s41390-018-0252-0
