Sujith Pereira1,2, Jonathan Reeves3, Malcolm Birch3, Sakthi Finton-James4, Komal Verma4, Robert Krug4, Ajay Sinha2,5, Stephen Kempley2. 1. Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London, UK. 2. Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK. 3. Clinical Physics, Royal London Hospital, Barts Health NHS Trust, London, UK. 4. Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK. 5. Neonatal Unit, Royal London Hospital, Barts Health NHS Trust, London, UK.
Abstract
INTRODUCTION: Cerebral blood flow is increasingly monitored in preterm infants. Doppler ultrasound of the carotid artery is a widely available method but is operator dependent. Our aim was to design and produce a realistic flow phantom model of the carotid artery of preterm infants. METHODS: Data from cerebral blood flow measurements using Doppler ultrasound of the right common carotid artery from 21 premature newborn infants were used to produce a Doppler flow phantom model with three different vessel diameters. Vessel diameter, continuous and pulsatile flow volume measurements were performed by two blinded observers (with more than eight and 20 years of experience). RESULTS: Vessel diameter measurements using the phantom were underestimated by 7%. Continuous flow volume measurements were overestimated by 7% by both observers (observer 1 mean difference 1.5 ± 1.96 SD -3.3 to 6.3 ml/min versus observer 2, 1.9 ± 1.96 SD -3.6 to 7.4 ml/min). Pulsatile flow measurements were overestimated by 12.6% by observer 1 (2.7 ± 1.96 SD -0.6 to 5.9 ml/min) and by 7.8% by observer 2 (1.7 ± 1.96 SD -1.6 to 4.9 ml/min). There was good interobserver and intraobserver reliability for the majority of measurements using continuous and pulsatile flow. CONCLUSION: It is feasible to produce a realistic flow phantom model of the neonatal carotid artery of preterm infants. Diameter measurements were underestimated and flow measurements were overestimated. These errors fell within acceptable limits for in vivo measurements. If these limitations were related to materials, this could be explored using a wall-less model. The flow phantom could be utilised for research and training clinicians in measuring cerebral blood flow using the carotid artery in this vulnerable group of infants.
INTRODUCTION: Cerebral blood flow is increasingly monitored in preterm infants. Doppler ultrasound of the carotid artery is a widely available method but is operator dependent. Our aim was to design and produce a realistic flow phantom model of the carotid artery of preterm infants. METHODS: Data from cerebral blood flow measurements using Doppler ultrasound of the right common carotid artery from 21 premature newborn infants were used to produce a Doppler flow phantom model with three different vessel diameters. Vessel diameter, continuous and pulsatile flow volume measurements were performed by two blinded observers (with more than eight and 20 years of experience). RESULTS: Vessel diameter measurements using the phantom were underestimated by 7%. Continuous flow volume measurements were overestimated by 7% by both observers (observer 1 mean difference 1.5 ± 1.96 SD -3.3 to 6.3 ml/min versus observer 2, 1.9 ± 1.96 SD -3.6 to 7.4 ml/min). Pulsatile flow measurements were overestimated by 12.6% by observer 1 (2.7 ± 1.96 SD -0.6 to 5.9 ml/min) and by 7.8% by observer 2 (1.7 ± 1.96 SD -1.6 to 4.9 ml/min). There was good interobserver and intraobserver reliability for the majority of measurements using continuous and pulsatile flow. CONCLUSION: It is feasible to produce a realistic flow phantom model of the neonatal carotid artery of preterm infants. Diameter measurements were underestimated and flow measurements were overestimated. These errors fell within acceptable limits for in vivo measurements. If these limitations were related to materials, this could be explored using a wall-less model. The flow phantom could be utilised for research and training clinicians in measuring cerebral blood flow using the carotid artery in this vulnerable group of infants.
Authors: Edile M Murdoch; Ajay K Sinha; Shanti T Shanmugalingam; Gordon C S Smith; Stephen T Kempley Journal: Pediatrics Date: 2006-11 Impact factor: 7.124
Authors: Fleur A Camfferman; Ginette M Ecury-Goossen; Jhuresy E La Roche; Nico de Jong; Willem van 't Leven; Hendrik J Vos; Martin D Verweij; Kazem Nasserinejad; Filip Cools; Paul Govaert; Jeroen Dudink Journal: Front Hum Neurosci Date: 2015-01-13 Impact factor: 3.169
Authors: Ammar A Oglat; M Z Matjafri; Nursakinah Suardi; Mohammad A Oqlat; Mostafa A Abdelrahman; Ahmad A Oqlat; Omar F Farhat; Batool N Alkhateb; Raed Abdalrheem; Muntaser S Ahmad; Mohammed Y M Abujazar Journal: J Med Ultrasound Date: 2018-05-07