Metabolic bone disease (MBD) is one of the major complications of prematurity. Ultrasonic backscatter technique has the potential to be a portable and noninvasive method for early diagnosis of MBD. This study firstly applied CAS to neonates, which was defined as a linear combination of the apparent integrated backscatter coefficient (AIB) and spectral centroid shift (SCS). The objective was to evaluate the feasibility of ultrasonic backscatter technique for assessing neonatal bone health using AIB, SCS, and CAS. Ultrasonic backscatter measurements at 3.5 MHz, 5.0 MHz, and 7.5 MHz were performed on a total of 505 newborns within 48 hours after birth. The values of backscatter parameters were calculated and compared among gestational age groups. Correlations between backscatter parameters, gestational age, anthropometric indices, and biochemical markers were analyzed. The optimal predicting models for CAS were determined. The results showed term infants had lower SCS and higher AIB and CAS than preterm infants. Gestational age and anthropometric indices were negatively correlated with SCS (|r| = 0.45 - 0.57, P < 0.001), and positively correlated with AIB (|r| = 0.36 - 0.60, P < 0.001) and CAS (|r| = 0.56 - 0.69, P < 0.001). Biochemical markers yielded weak or nonsignificant correlations with backscatter parameters. CAS had relatively stronger correlations with the neonatal variables than AIB and SCS. At 3.5 MHz and 5.0 MHz, only gestational age (P < 0.001) independently contributed to the measurements of CAS, and could explain up to 40.5% - 44.3% of CAS variation. At 7.5 MHz, the combination of gestational age (P < 0.001), head circumference (P = 0.002), and serum calcium (P = 0.037) explained up to 40.3% of CAS variation. This study suggested ultrasonic backscatter technique was feasible to evaluate neonatal bone status. CAS was a promising parameter to provide more information about bone health than AIB or SCS alone.

中文翻译：

---

用于新生儿骨状态评估的组合超声反向散射参数。

代谢性骨病（MBD）是早产的主要并发症之一。超声反向散射技术有可能成为MBD早期诊断的一种便携式无创方法。这项研究首先将CAS应用于新生儿，这被定义为表观积分后向散射系数（AIB）和光谱质心位移（SCS）的线性组合。目的是评估使用AIB，SCS和CAS的超声反向散射技术评估新生儿骨骼健康的可行性。出生后48小时内，对505个新生儿进行了3.5 MHz，5.0 MHz和7.5 MHz的超声反向散射测量。计算并比较了各个胎龄组的反向散射参数值。反向散射参数，胎龄，人体测量学指标，并分析生化标记。确定了CAS的最佳预测模型。结果表明，足月儿比早产儿的SCS更低，AIB和CAS更高。妊娠年龄和人体测量指标与SCS呈负相关（| r | = 0.45-0.57，P <0.001），与AIB（| r | = 0.36-0.60，P <0.001）和CAS（| r | = 0.56）正相关-0.69，P <0.001）。生化标记与反向散射参数之间存在弱或非显着相关性。CAS与新生儿变量的相关性比AIB和SCS强。在3.5 MHz和5.0 MHz时，只有胎龄（P <0.001）独立地影响CAS的测量，并且可以解释高达40.5％-44.3％的CAS变化。在7.5 MHz时，胎龄（P <0.001），头围（P = 0.002），血清钙（P = 0.037）解释了高达40.3％的CAS变化。这项研究表明超声反向散射技术是可行的评估新生儿骨骼状况。与单独使用AIB或SCS相比，CAS是提供更多有关骨骼健康信息的有前途的参数。