Citation Information :
McLean G, Razak A, Ditchfield M, Lombardo P, Malhotra A. Evaluation of a Cranial Ultrasound Scoring System for Prediction of Abnormal Early Neurodevelopment in Preterm Infants. 2023; 2 (2):122-127.
Aim: To evaluate and compare a cranial ultrasound (cUS) scoring system to conventional reporting of cranial ultrasound abnormalities (CUAs) for prediction of early neurodevelopmental outcomes in preterm infants.
Materials and methods: This retrospective, single-center study compared cUS scores to results from late ultrasound examination reports for any cUS abnormality (CUA) (any hemorrhage or white matter lesion) or severe CUA [severe intraventricular hemorrhage (IVH)], cystic periventricular leukomalacia (PVL), parenchymal or cerebellar hemorrhage) for predicting early signs of cerebral palsy (CP) or developmental delay in preterm infants.
Results: Six-weeks postnatal cUS examinations were analyzed against early neurodevelopmental outcomes at 3–4-months corrected age of 242 preterm infants (median gestational age, 26.5 weeks; interquartile range [IQR, 4 weeks] and median body weight 880 grams [IQR, 356.5 grams]). We did not find any statistically significant differences between cUS score and any CUA for sensitivity (57% vs 57% [95% confidence interval (CI): from −19 to 19]) and specificity (68% vs 64% [95% CI: from −3 to 10]) for predicting CP. Similarly, there was no difference in sensitivity (44% vs 46% [95% CI: from −12 to 7]) and specificity (74% vs 70% [95% CI: from −5 to 13]) for predicting any developmental delay. However, in comparison to severe CUA, cUS score had significantly higher sensitivity (57% vs 27% [95% CI: from 12 to 49]) but significantly lower specificity (68% vs 96% [95% CI: from −21 to −34]) for predicting CP. There was higher sensitivity (44% vs 12 % [95% CI: from 23 to 41]) but lower specificity (74% vs 98% [95% CI: from −15 to −32]) for any delay.
Conclusions: Cranial ultrasound score was similar to any reported CUA for predicting neurodevelopmental outcomes; however, when compared to severe CUA, it had better sensitivity but poor specificity for predicting early neurodevelopmental outcomes.
Clinical significance: Objective scoring of cUS examinations on late neonatal scans was found to be similar to conventional reporting of any CUA for the prediction of early neurodevelopmental outcomes in this retrospective study. This indicates that scoring does not value add to the diagnosis of these infants.
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