Texture analysis of periventricular echogenicity on neonatal cranial ultrasound predicts periventricular leukomalacia

摘要

Abstract. BACKGROUND: White matter periventricular echogenicity detected in neonatal cranial ultrasound (US) scans may be followed by cystic periventricular leukomalacia (PVL) or might resolve. Serial US are therefore needed to clarify the outcome. Texture analysis is a computerized method to analyze images and distinguish findings that are undetectable by the human eye. OBJECTIVE: To test whether texture analysis can differentiate echogenicities that resolve from those that develop cystic PVL. MATERIAL AND METHODS: Neonates with echogenicities on their initial US scan were studied; texture analysis was performed on the coronal and sagittal sections. Texture parameters were entered into a linear discriminant analysis (LDA) to classify the scans along two axes called most discriminant features (MDF) 1 and 2. RESULTS: We studied twenty infants with periventricular echogenicities on initial scans; ten of them later resolved (group A), while the other ten infants developed cystic PVL (group B). The classification accuracy was 66% and 82% for group A and B on sagittal sections, and 75%, and 80% on coronal. In the coronal and sagittal plane respectively, a MDF1 value of 0.98 and 0.24 and an MDF2 value of 0.86 and 0.001 provided the best sensitivity, specificity, positive and negative likelihood ratio. CONCLUSION: Texture analysis is-rpromising objective tool to early identify which cranial echogenicity that will develop into cystic PVL. Because it is noninvasive, inexpensive, portable and requires no sedation, cranial ultrasound (US) scanning is routinely and serially performed in very low birth weight (VLBW) neonates. Its main aim is to diagnose central nervous system complications, such as white matter damage (WMD), which occurs in these infants. Periventricular echogenicity (PVE) of the white matter is sometimes seen on early scans. It is often transient and resolves spontaneously with no increased risk of neurodevelopment complications. Sometimes it evolves several weeks later into cystic periventricular leukomalacia (PVL); that is associated with cerebral palsy and neurodevelopment disability.