Development of an Ultrasound Scoring System to Describe Brain Maturation in Preterm Infants.

Abstract

Cerebral maturation in preterm infants predominantly occurs postnatally, necessitating the development of objective bedside markers to monitor this process. This study aimed to develop a straightforward objective Ultrasound Score of Brain Development to assess cortical development in preterm infants. A total of 344 serial ultrasound examinations from 94 preterm infants born at ≤ 32 weeks of gestation were analyzed to identify brain structures suitable for a scoring system. Among 11 candidate structures, 3 cerebral landmarks were selected due to their correlation with gestational age: the interopercular opening (P < .001), the height of the insular cortex (P < .001), and the depth of the cingulate sulcus (P < .001). These structures can be easily visualized in a single midcoronal view in the plane through the third ventricle and the foramina of Monro. A score point from 0 to 2 was assigned to each measurement, culminating in a total score ranging from 0 to 6. The Ultrasound Score of Brain Development correlated significantly with gestational age (P < .001). The proposed Ultrasound Score of Brain Development has the potential for application as an objective indicator of brain maturation in correlation with gestational age, circumventing the need to rely on individual growth trajectories and percentiles for each specific structure.