Ultrafast Power Doppler Imaging of Human Newborn with Periventricular Venous Infarction: A Pilot Study

Intraventricular hemorrhage (IVH) is a common disease in preterm neonates. Severe IVH may result in periventricular venous infarction (PVI) which often coexists with periventricular leukomalacia (PVL). PVI accompanied by PVL often leads to severe neurological sequelae. Current inspection methods for PVI and PVL include cranial ultrasound (cUS) imaging and magnetic resonance imaging (MRI). However, only anatomical information can be obtained from these two imaging modalities. Studies demonstrate that the morphology and hemodynamics of microvessels are related to pathological changes in some diseases, which cannot be detected using conventional ultrasound Doppler imaging. Recently, ultrafast power Doppler imaging (uPDI) has been developed to visualize the microvasculature. In this study, the feasibility of uPDI in a human neonate with PVI accompanied by PVL is validated. The microvascular supply of one normal section and two diseased sections with PVL were evaluated by calculating the microvascular density (MD) and power Doppler density (PDD) indexes. Results show that the microvascular supply of brain parenchyma in the diseased sections is higher than that in the normal section, which can be explained as compensatory responses. In conclusion, uPDI has the potential to assess the microvascular supply and predict the prognosis of neonates with PVI or PVL.