A COMPARATIVE STUDY TO DETERMINE THE ROLE OF SHEAR WAVE ELASTOGRAPHY OF BRAIN PARENCHYMA IN PRETERM AND TERM NEONATES

Abstract

Introduction: Birth before the 37th week of pregnancy is known as prematurity, and it is a major global health issue. Premature births can cause a wide range of disabilities in their victims, from moderate developmental delays to complete neurological destruction. Among the neurologic aftereffects, cerebral palsy poses a 5% to 10% risk to preterm newborns, while cognitive, behavioral, or communication impairments pose a 50% risk. As is the case with many organ systems, a greater understanding of the pathogeneses and prognoses of disease requires an understanding of the stiffness of brain tissues. In this way, knowledge of the stiffness of the newborn brain is necessary to comprehend the neurologic disorders resulting from preterm birth. The purpose of this study was to assess the stiffness of the neonatal brain in term and preterm neonates using 2-dimensional shear wave elastography and to investigate potential stiffness variations between these groups. Aim: 1. To assess the stiffness of the neonatal brain using the SWE method in term and preterm neonates. 2. To evaluate possible differences in elasticity between groups. 3. To derive a cut off reference range for evaluating neonatal brain stiffness between preterm and term neonates. 4. To predict possibility of future brain injuries related to prematurity. Methods: This prospective study carried out over a period of 18 months involving 41 term and 41 preterm infants. Patients with suspected congenital malformations, Central nervous system infections, cerebral hemorrhage, Hydrocephalus, Periventricular leukomalacia and insufficient fontanel space were excluded from the study. Comparison of continuous variable xvii (gestational age, SWE values for thalamus, periventricular white matter) across the groups (term vs pre-term group) was performed using the student’s t test. Chi square test will be used to compare categorical variables (sex, etc.) between research groups. A P-value of less than 0.05 was deemed statistically noteworthy. Results: The mean thalamus SWE (kPa) was higher in term deliveries (8.825 ± 0.3754) compared to preterm 7.805±0.5901 (P < 0.001). The mean periventricular white matter SWE (kPa) was higher in term deliveries (7.298 ± 0.4300) compared to preterm, 6.538±0.5300 (P < 0.001). The cut-off value of SWE of mean thalamus, kPa < 8.35 predicted the preterm delivery with 95% sensitivity and 87.5% specificity. The cut-off value of SWE of mean periventricular white matter, kPa) < 6.85 predicted the preterm delivery with 87.5% sensitivity and 72.5% specificity. Conclusion: Preterm neonates had stiffer thalamus and periventricular white matter than term neonates, with the thalamus having stiffer values than the periventricular white matter. The mean thalamus and mean periventricular white matter stiffness cut off values that were most effective in identifying preterm were 8.35 kPa and 6.85 kPa, respectively.