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Session: Birth & Neonates
Session starts: Thursday 24 January, 13:30
Presentation starts: 14:00
Room: Lecture room 558

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Jorinde Kortenbout ()
Rik Vos ()
Jeroen Dudink ()
Paul Govaert ()
Martin Verweij ()
Michiel Pertijs ()
Nico de Jong ()

Abstract:
Very preterm neonates (24-32 weeks of gestation) are born in a critical period of brain development and maturation. The brain is extremely vulnerable in this period and injuries during this phase may lead to long term cognitive, motor and behavioural problems. Adequate brain perfusion is important in prevention of preterm brain injury [1]. Objective continuous monitoring of brain perfusion is not yet possible in the neonatal intensive care (NICU). In the NICU, conventional ultrasound is used for evaluation of the neonatal brain anatomy and detection of brain injury [2]. High frame rate (HFR) ultrasound (>1000 Hz) enables sensitive vascular imaging and non-invasive elasticity imaging [3]. To permit continuous HFR neonatal brain monitoring a trans-fontanel ultrasound probe (MIFFY probe) will be developed. Volumetric (3D) ultrasound data of the premature brain will be acquired in HFR to obtain high resolution grey scale images, perfusion images of the vascular tree and elasticity images. RF data will be collected with a wide opening angle and a broad frequency band through the anterior fontanel every ten minutes, during at least one cardiac cycle. The high frequency probe makes it possible to image and quantify flow in vessels with a size of 100-200 µm. The method is sensitive for slow flow as well and even subtle changes in hemodynamics can be detected. Since the data will be acquired every ten minutes, the infant can act as its own reference, so that an alarm can be given if the perfusion changes significantly. The dataset will also be used to generate elasticity images. These images give information about local stiffness of the preterm brain. We are currently developing this technique in stiffness phantoms. The aim is to explore the natural occurring shear waves (heartbeat, breathing) and this might provide information of changes in tissue stiffness after perfusion deficiencies. The MIFFY probe with high resolution will have the ability to improve diagnostic value, since minor changes in perfusion or elasticity can be measured in a timely manner to provide continuous neuromonitoring in the most critical days of neonatal intensive care.