Two-dimensional cranial ultrasounds and microvascular blood flow (MV-Flow) tests could detect early-stage brain damage in newborns with increased bilirubin levels (hyperbilirubinemia) due to hemolytic disease of the fetus and newborn, according to a recently published study in scientific reports.
Hyperbilirubinemia damages the blood vessel cells in the brain, allowing blood to flow into certain brain regions. In the early stages, this blood flow is microscopic, and its detection could enable physicians to take appropriate measures before the condition progresses.
“In this study, we explore the correlation between bilirubin-induced damage to the central nervous system and changes in microblood flow within specific brain regions using MV-Flow imaging,” the authors wrote.
The study included 85 newborns who underwent cranial ultrasonography between 2022 and 2023. The patients were divided into two groups: one with hyperbilirubinemia (51 patients) and one without (34 patients). The cut-off bilirubin value to define hyperbilirubinemia was 300 and 428 µmol/L.
Results showed that patients with hyperbilirubinemia had a significantly higher rate of microbleeds than patients in the other group. Furthermore, patients in the hyperbilirubinemia group had an altered Globus Pallidus to Putamen (G/P) ratio, which suggests fundamental alterations in cerebral structure.
These results suggest that newborns with bilirubin levels above 300 µmol/L should be monitored for neurological damage. However, the authors recognized the small sample size and the lack of follow-up as significant limitations and remarked on the need for more research to confirm the findings.
“MV-Flow technology shows promise not only in revealing microflow characteristics and quantifying basal ganglia microvascular structure but also in tracking cerebral microflow changes before brain tissue alterations occur,” the authors wrote. “ Early detection of bilirubin-induced brain changes can help promptly alert clinicians to potential brain damage,”
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