Added Value of Microvascular Imaging for the Diagnosis and Monitoring of Strokes in Newborns and Infants

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-01-16 DOI:10.1016/j.pediatrneurol.2025.01.010

Santiago Martinez-Correa MD , Colbey W. Freeman MD , Wondwossen T. Lerebo PhD , Benjamin H. Taragin MD , Austin Moats MD , Sophie Haddad MD , Luis Octavio Tierradentro-Garcia MD , Misun Hwang MD

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引用次数: 0

Abstract

Background

Neonatal/infantile stroke is a catastrophic condition associated with significant mortality and morbidity. Magnetic resonance imaging (MRI) remains the preferred modality for detecting ischemic stroke but has procedural limitations. Microvascular imaging (MVI) ultrasound (US) allows accurate visualization of the microvasculature. We assessed the added value of MVI to improve the detection of stroke diagnosis in neonates and infants.

Methods

We retrospectively identified patients younger than one year who underwent brain US with MVI for suspected or confirmed stroke between January 2020 and June 2023. All patients had confirmed strokes on US and/or subsequent computed tomography or MRI. A pediatric radiologist (reader 1), a neuroradiologist (reader 2), and a pediatric radiology fellow (reader 3), unaware of the results, individually evaluated the US images to detect strokes. We used the McNemar test to determine the difference in responses before and after MVI.

Results

Our cohort had 11 infants, nine boys and two girls (median age 61 days [13.5 to 145.5]). The three readers performed significantly better at stroke diagnosis with MVI (29 correct of 33) compared with grayscale US alone (13 of 33) (P < 0.001). Reader 1 improved from seven of 11 correct diagnoses to 11 of 11 (P = 0.045), reader 2 improved from five of 11 to 10 of 11 (P = 0.025), and reader 3 improved from one of 11 to eight of 11 (P < 0.001).

Conclusions

Our preliminary findings suggest that MVI has potential as a complementary tool to standard brain US protocols for neonatal and infant stroke assessment.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.