Liping Sun, Wei Ji, Kan Zhang, Hualin Chen, Hong Wang, Jijian Zheng, Yue Huang
SWE identified significant postoperative reductions in the stiffness of PVWM and TH in infants with CHD. The body and caudal PVWM, as well as caudal TH, showed the most prominent changes. PVWM consistently presented lower stiffness than TH during the entire perioperative period. SWE proves feasible for quantitative evaluation of minor cerebral changes in affected infants during the perioperative period.
OBJECTIVE: To quantitatively evaluate stiffness changes in the periventricular white matter (PVWM) and thalamus (TH) in infants undergoing congenital cardiac surgery using shear wave elastography (SWE).
DESIGN: A prospective observational study.
SETTING: Single-center study based at a tertiary care center.
PATIENTS: Forty-three infants aged zero-to-six months with congenital heart disease (CHD) undergoing cardiac surgery with cardiopulmonary bypass (CPB) were enrolled.
INTERVENTIONS: SWE was performed to measure periventricular white matter and thalamic stiffness before and after surgery.
MEASUREMENTS AND MAIN RESULTS: No significant correlation was observed between age and the stiffness of either PVMW or TH, both before and after surgery. Significant postoperative reductions were observed in mean stiffness of PVMW (1.22 ± 0.14 m/s vs. 1.18 ± 0.14 m/s, p = 0.014) and TH (1.54 ± 0.15 m/s vs. 1.50 ± 0.15 m/s, p = 0.031). Regional analysis of PVWM and TH indicated a significant postoperative decrease in tissue stiffness, with notable reductions observed in the body portion of PVWM (1.24 ± 0.13 m/s vs. 1.18 ± 0.15 m/s, p = 0.046), the caudal portion of PVWM (1.22 ± 0.14 m/s vs. 1.18 ± 0.13 m/s, p = 0.045), and the caudal portion of TH (1.53 ± 0.16 m/s vs. 1.45 ± 0.16 m/s, p = 0.014). Consistently, PVWM demonstrated lower stiffness than TH, both before surgery (1.22 ± 0.14 m/s vs. 1.54 ± 0.15 m/s, p < 0.001) and after surgery (1.18 ± 0.14 m/s vs. 1.50 ± 0.15 m/s, p < 0.001).
CONCLUSIONS: SWE identified significant postoperative reductions in the stiffness of PVWM and TH in infants with CHD. The body and caudal PVWM, as well as caudal TH, showed the most prominent changes. PVWM consistently presented lower stiffness than TH during the entire perioperative period. SWE proves feasible for quantitative evaluation of minor cerebral changes in affected infants during the perioperative period.