Intraventricular (IVH) and periventricular (PVH) hemorrhages in preterm neonates are common because the periventricular blood vessels are still developing up to 36 weeks and are fragile. Currently, transfontanelle ultrasound (US) imaging is utilized for screening for IVH and PVH, largely through the anterior fontanelle. However for mild hemorrhages, inconclusive diagnoses are common, leading to failure to detect IVH/PVH or, when other clinical symptoms are present, use of second stage neuroimaging modalities requiring transport of vulnerable patients. Yet even mild IVH/PVH increases the risk of moderate-severe neurodevelopmental impairment. Here, we demonstrate the capability of transfontanelle photoacoustic imaging (TFPAI) to detect IVH and PVH in-vivo in a large animal model. TFPAI was able to detect IVH/PVH as small as 0.3 mL in volume in the brain (p < 0.05). By contrast, US was able to detect hemorrhages as small as 0.5 mL. These preliminary results suggest TFPAI could be translated into a portable bedside imaging probe for improved diagnosis of clinically relevant brain hemorrhages in neonates.

早产儿脑室内 (IVH) 和脑室周围 (PVH) 出血很常见，因为脑室周围血管在 36 周内仍在发育且脆弱。目前，经囟门超声 (US) 成像主要通过前囟用于筛查 IVH 和 PVH。然而，对于轻度出血，不确定的诊断很常见，导致无法检测 IVH/PVH，或者当存在其他临床症状时，使用需要转运易受影响患者的第二阶段神经影像检查方式。然而，即使是轻微的 IVH/PVH 也会增加中度至重度神经发育障碍的风险。在这里，我们展示了跨囟光声成像 (TFPAI)在大型动物模型中检测体内IVH 和 PVH 的能力。 TFPAI 能够检测 大脑中体积小至 0.3 mL 的 IVH/PVH ( p < 0.05)。相比之下，US 能够检测到小至 0.5  mL 的出血。这些初步结果表明，TFPAI 可以转化为便携式床边成像探头，以改善对新生儿临床相关脑出血的诊断。