3D Ultrasound Assessment of the Central Sulcus in Very Preterm Infants: Feasibility and Reproducibility of Opening Metrics Study

3D Ultrasound Assessment of the Central Sulcus in Very Preterm Infants: Feasibility and Reproducibility of Opening Metrics Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article 3D Ultrasound Assessment of the Central Sulcus in Very Preterm Infants: Feasibility and Reproducibility of Opening Metrics Study Carmen Rodríguez Barrios, Irene Gutiérrez Rosa, Simon Pedro Lubian Fernández, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8108217/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 26 Mar, 2026 Read the published version in Scientific Reports → Version 1 posted 10 You are reading this latest preprint version Abstract Quantitative studies of cortical development in preterm infants are needed. Until now, magnetic resonance imaging (MRI) has been the only technique capable of providing these 3D measurements. However, bedside ultrasound may offer a more accessible, repeatable alternative for both clinical and research applications. To assess the feasibility and reproducibility of three-dimensional transfontanellar ultrasound (3D US) for the semi-automated quantification of central sulcus (CS) morphology in very preterm infants, we performed a prospective study acquiring 109 serial 3D US volumes from 13 infants born < 32 weeks’ gestation. Twelve CS morphometric parameters were extracted with a semi-automated pipeline; reliability was assessed with intra-class correlation coefficients (ICC), and maturational trends were modelled with linear mixed effects models. Single-sweep ICCs ranged from 0.15 (length) to 0.71 (mean opening), while averaging three sweeps improved reproducibility to 0.34–0.88 (highest ICC 0.88, 95% CI 0.74–0.95). CS length increased from 25.9 ± 9.8 mm at 24 weeks to 34.3 ± 8.9 mm at 36 weeks post-menstrual age (p = 0.006), and mean sulcal opening from 4.0 ± 1.8 mm to 5.7 ± 1.9 mm (p = 0.023). The right hemisphere consistently showed larger openings than the left (5.4 ± 1.3 mm vs 3.2 ± 1.5 mm; p < 0.0001). 3D US-based CS metrics thus capture lateralised, maturational changes and, when multiple sweeps are averaged, achieve good reproducibility (ICC up to 0.88), supporting their use for serial monitoring of cortical folding in the neonatal intensive care unit (NICU). Health sciences/Anatomy Physical sciences/Engineering Health sciences/Health care Health sciences/Medical research Central sulcus preterm 3D ultrasound cortical folding Full Text Additional Declarations No competing interests reported. Supplementary Files supplementarymaterialscireports.docx Cite Share Download PDF Status: Published Journal Publication published 26 Mar, 2026 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 09 Jan, 2026 Reviews received at journal 22 Dec, 2025 Reviews received at journal 22 Dec, 2025 Reviewers agreed at journal 22 Dec, 2025 Reviewers agreed at journal 16 Dec, 2025 Reviewers invited by journal 16 Dec, 2025 Editor assigned by journal 16 Dec, 2025 Editor invited by journal 05 Dec, 2025 Submission checks completed at journal 21 Nov, 2025 First submitted to journal 21 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8108217","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":561234584,"identity":"afb45973-e296-4388-9ce9-0b99116bf6c7","order_by":0,"name":"Carmen Rodríguez Barrios","email":"","orcid":"","institution":"Puerta del Mar University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Carmen","middleName":"Rodríguez","lastName":"Barrios","suffix":""},{"id":561234585,"identity":"cb63e694-dff0-4378-b736-31826f148dc6","order_by":1,"name":"Irene Gutiérrez Rosa","email":"","orcid":"","institution":"Puerta del Mar University 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Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Central sulcus, preterm, 3D ultrasound, cortical folding","lastPublishedDoi":"10.21203/rs.3.rs-8108217/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8108217/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eQuantitative studies of cortical development in preterm infants are needed. Until now, magnetic resonance imaging (MRI) has been the only technique capable of providing these 3D measurements. However, bedside ultrasound may offer a more accessible, repeatable alternative for both clinical and research applications. To assess the feasibility and reproducibility of three-dimensional transfontanellar ultrasound (3D US) for the semi-automated quantification of central sulcus (CS) morphology in very preterm infants, we performed a prospective study acquiring 109 serial 3D US volumes from 13 infants born\u0026thinsp;\u0026lt;\u0026thinsp;32 weeks\u0026rsquo; gestation. Twelve CS morphometric parameters were extracted with a semi-automated pipeline; reliability was assessed with intra-class correlation coefficients (ICC), and maturational trends were modelled with linear mixed effects models. Single-sweep ICCs ranged from 0.15 (length) to 0.71 (mean opening), while averaging three sweeps improved reproducibility to 0.34\u0026ndash;0.88\u003c/p\u003e \u003cp\u003e(highest ICC 0.88, 95% CI 0.74\u0026ndash;0.95). CS length increased from 25.9\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8 mm at 24 weeks to 34.3\u0026thinsp;\u0026plusmn;\u0026thinsp;8.9 mm at 36 weeks post-menstrual age (p\u0026thinsp;=\u0026thinsp;0.006), and mean sulcal opening from 4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8 mm to 5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9 mm (p\u0026thinsp;=\u0026thinsp;0.023). The right hemisphere consistently showed larger openings than the left (5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3 mm vs 3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 mm; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). 3D US-based CS metrics thus capture lateralised, maturational changes and, when multiple sweeps are averaged, achieve good reproducibility (ICC up to 0.88), supporting their use for serial monitoring of cortical folding in the neonatal intensive care unit (NICU).\u003c/p\u003e","manuscriptTitle":"3D Ultrasound Assessment of the Central Sulcus in Very Preterm Infants: Feasibility and Reproducibility of Opening Metrics Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-18 16:26:49","doi":"10.21203/rs.3.rs-8108217/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-09T12:02:27+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-22T09:44:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-22T09:07:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"38244645176821276514441763502206655974","date":"2025-12-22T07:14:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"55163259858710284831814562092905912994","date":"2025-12-16T14:20:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-16T09:16:28+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-16T09:07:35+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-05T11:38:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-21T12:20:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-11-21T12:17:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"af88697f-07ee-45eb-8930-79c33dcfebc4","owner":[],"postedDate":"December 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":59756032,"name":"Health sciences/Anatomy"},{"id":59756033,"name":"Physical sciences/Engineering"},{"id":59756034,"name":"Health sciences/Health care"},{"id":59756035,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-03-30T16:28:17+00:00","versionOfRecord":{"articleIdentity":"rs-8108217","link":"https://doi.org/10.1038/s41598-026-40148-8","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2026-03-26 16:10:43","publishedOnDateReadable":"March 26th, 2026"},"versionCreatedAt":"2025-12-18 16:26:49","video":"","vorDoi":"10.1038/s41598-026-40148-8","vorDoiUrl":"https://doi.org/10.1038/s41598-026-40148-8","workflowStages":[]},"version":"v1","identity":"rs-8108217","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8108217","identity":"rs-8108217","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}