Diagnostic Accuracy of Longitudinal Evaluation of Central Nervous System Sonoelastography in Preterm and Term Neonates.

OBJECTIVES: The objective of this study was to evaluate the brain elasticity of the central nervous system in preterm and term neonates. METHODS: Seventy-seven healthy preterm and term neonates (mean gestational age [GA], 37.5 weeks; range, 32.6-40.5 weeks) were included in the study. Periventricular and subcortical white matter, cortical gray matter, and ventricle and subdural spaces were examined with strain elastography ratios. Each patient underwent sonography evaluation twice. The mean age at the time of sonographic evaluation was 9 days (range, 4-15 days) for the first evaluation and 37 days (range, 31-47 days) for the second evaluation. The ratios were correlated with GA, birth weight. RESULTS: The caudate nucleus and cortical gray matter strain ratios were significantly higher than the periventricular and subcortical white matter strain ratios (P < 0.001). There was a positive relationship between GA and periventricular white matter elastographic scores on the two measurements (P = 0.022 and 0.018, respectively). The term neonates have higher strain rations compared with the preterm neonates at the first assessment (P < 0.01). At the evaluation of the area under the curve for the sonographic examination for the receiver operating characteristic curve, the periventricular white matter was 0.742 (95% confidence interval, 0.689-0.790), and it was 0.773 (95% confidence interval, 0.722-0.818) for the subcortical white matter. CONCLUSIONS: Neonatal brain development, maturation, and myelination can be assessed by strain elastography. These findings should be evaluated with further larger cohorts that could help to prevent neonatal brain damages.

Bedside ultrasonography for the confirmation of gastric tube placement in the neonate.

BACKGROUND: Naso/Orogastric tube (NOGT) misplacement can lead to significant complications. Therefore, the assessment of tube position is essential to ensure patient safety. Although radiography is considered the gold standard for determining NOGT location, new methods may be helpful in reducing repetitive radiation exposure, especially for neonates. In this study, we sought to investigate if bedside ultrasonography (BUSG) can be used to verify NOGT placement in neonatal intensive care patients. MATERIALS AND METHODS: Infants requiring NOGT placement were enrolled. After insertion of the NOGT, the location was first identified using BUSG and then confirmed using abdominal radiography for comparison. RESULTS: The study cohort included 51 infants with an average gestational age of 34 ± 4.9 weeks. BUSG determined the NOGT location correctly with a sensitivity of 92.2%. The location of the NOGT could not be determined by BUSG in four neonates (7.8%). In one infant, the NOGT was positioned in the esophagus, as determined both by BUSG and radiography. CONCLUSION: BUSG is a promising diagnostic tool for determining NOGT location in neonates, thereby eliminating the need for abdominal radiography.