Extremely preterm infants’ hemodynamic instability places them at high risk of brain injury. Currently there is no reliable bedside method to continuously monitor cerebral hemodynamics in the neonatal intensive care unit (NICU). This paper reports a feasibility study to adapt and test an innovative speckle contrast diffuse correlation tomography (scDCT) device for noncontact, high-density, 3D imaging of cerebral blood flow (CBF) in preterm infants. The scDCT scans a focused point near-infrared illumination to multiple source positions for deep tissue penetration, and controls an electron multiplying charge-coupled-device camera with thousands of pixels to achieve a high-density sampling. The optimized scDCT for use in preterm infants was first evaluated against an established diffuse correlation spectroscopy in an infant-head-simulating phantom with known properties. The observed significant correlation between the two measurements verified the capability of scDCT for transcranial brain imaging. The insignificant influence of transparent incubator wall on scDCT measurements was then confirmed by comparing adult forearm blood flow responses to artery cuff occlusions measured inside and outside the incubator. Finally, the scDCT device was moved to the NICU to image CBF variations in two preterm infants. Infant #1 with no major organ deficits showed little CBF fluctuation over the first 3 weeks of life. Infant #2 showed a significant CBF increase after the 2 h pharmacotherapy for patent ductus arteriosus closure. While these CBF variations meet physiological expectations, the fact that no significant changes are noted with peripheral monitoring of blood oxygen saturation suggests necessity of direct cerebral monitoring. This feasibility study with timely technology development is an important and necessary step towards larger clinical studies with more subjects to further validate it for continuous monitoring and instant management of cerebral pathologies and interventions in the NICU.

极早产儿的血流动力学不稳定使他们处于脑损伤的高风险中。目前还没有可靠的床边方法来持续监测新生儿重症监护室 (NICU) 中的脑血流动力学。本文报告了一项可行性研究，以适应和测试一种用于早产儿脑血流 (CBF) 非接触式高密度 3D 成像的创新散斑对比扩散相关断层扫描 (scDCT) 设备。scDCT 将聚焦点近红外照明扫描到多个光源位置以进行深层组织穿透，并控制具有数千像素的电子倍增电荷耦合器件相机以实现高密度采样。用于早产儿的优化 scDCT 首先针对具有已知特性的婴儿头部模拟体模中已建立的漫反射相关光谱进行了评估。观察到的两次测量之间的显着相关性验证了 scDCT 用于经颅脑成像的能力。然后通过比较成人前臂血流反应与在培养箱内外测量的动脉袖带闭塞情况，证实了透明培养箱壁对 scDCT 测量的影响不大。最后，将 scDCT 设备移至 NICU 以对两名早产儿的 CBF 变化进行成像。没有主要器官缺陷的 1 号婴儿在生命的前 3 周内几乎没有显示 CBF 波动。2 号婴儿在动脉导管未闭闭合 2 小时药物治疗后显示 CBF 显着增加。虽然这些 CBF 变化符合生理预期，但外周血氧饱和度监测未发现显着变化这一事实表明直接脑监测的必要性。这项具有及时技术开发的可行性研究是朝着更大的临床研究迈出的重要且必要的一步，涉及更多受试者，以进一步验证其对 NICU 中脑病变和干预措施的持续监测和即时管理。