AIM: Pilot study to explore feasibility of a color Doppler technique for monitoring cerebral perfusion at the level of microvessels. METHODS: Between March 1st, 2011, and January 30th, 2013, all admitted infants born before 29 weeks of gestation were eligible for Doppler imaging. Perfusion images were acquired in a standard coronal plane. Image quality was assessed by two authors (MR, PG). The region of interest (ROI) was manually selected. A segmentation tool was developed to separate color data from the greyscale 2D images, leading to a percentage and number of color pixels in the image (Doppler color index; DCI). Intra-and inter-observer agreement was analyzed. RESULTS: Intra-and inter-observer agreement for placement of ROIs was good (bias-0.24 resp.-0.74 percentage points). Color Doppler was able to depict microvessels in cortex, white matter and deep grey matter. The median DCI in a region of cortex-white matter was 7.8% with a wide range (1.4%-25.6%). There was no significant difference between the left and right hemisphere (Mann-Whitney U, P-value 0.61). Clinically relevant observations were tabulated, e.g. distant effect of germinal matrix hemorrhage (GMH) on regional perfusion. CONCLUSION: Sonographic small vessel visualisation may help understand pathogenetic mechanisms related to perfusion and is valuable to monitor effects of treatment.
Raets, M. M. A., Govaert, P., Goos, T. G., Reiss, I. K. M., de Jonge, RCJ., & Dudink, J. (2014). Preterm cerebral microcirculation assessed with color Doppler: A pilot study. Journal of Pediatric Neuroradiology, 3(4), 155-160. https://doi.org/10.3233/PNR-14090