Cranial sonography in term and near-term infants (original) (raw)
Related papers
Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning
Journal of Korean Neurosurgical Society, 2010
Objective : To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian setup. Methods : The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated. Results : There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG. Conclusion : USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.
AJNR. American journal of neuroradiology, 2000
Sonography, CT, and MR imaging are commonly used to screen for neonatal intracranial ischemia and hemorrhage, yet few studies have attempted to determine which imaging technique is best suited for this purpose. The goals of this study were to compare sonography with CT and MR imaging prospectively for the detection of intracranial ischemia or hemorrhage and to determine the prognostic value(s) of neuroimaging in neonates suspected of having hypoxic-ischemic injury (HII). Forty-seven neonates underwent CT (n = 26) or MR imaging (n = 24) or both (n = 3) within the first month of life for suspected HII. Sonography was performed according to research protocol within an average of 14.4 +/- 9.6 hours of CT or MR imaging. A kappa analysis of interobserver agreement was conducted using three independent observers. Infants underwent neurodevelopmental assessment at ages 2 months (n = 47) and 2 years (n = 26). CT and MR imaging had significantly higher interobserver agreement (P < .001) fo...
2019
Background: Perinatal asphyxia plays a major role in neonatal morbidity and death throughout the world. An estimated 130 million infants are born each year, of which 4 million die within first 28 days of life. Pakistan has the third highest neonatal death rate in the world with incidence of prenatal asphyxia reaching up to 9%. Magnetic resonance imaging (MRI) of the brain is the standard imaging modality in such cases, but a good correlation between cranial sonography and MRI of brain has been reported. The aim of this study was to determine diagnostic accuracy of cranial sonography in detection of neonatal hypoxic ischemic encephalopathy (HIE) in clinically suspected premature neonates. Patients and methods: This cross-sectional survey was conducted in Sir Ganga Ram Hospital, Department of Radiology and Medical Imaging between March-August, 2017. Total 303 premature neonates were included in the study hospitalized in Neonatology unit of the hospital with clinical suspicion of hypoxic ischemic encephalopathy. Transcranial sonography (CUS) was performed in first month of life and findings were recorded. Then 1.5 Tesla MRI machine was used for imaging brain using T1-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. The sonographic results were then compared with MRI findings. Results: The mean age of mothers was 29.3years. The mean gestational age at birth was 33.9weeks. In this study, there were 157 (51.8%) males and 146 (48.2%) female neonates. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of cranial sonography were 97.8%, 96.0%, 97.2%, 96.8% and 97.0%, respectively taking MRI as gold standard. Conclusion: Cranial sonography has high accuracy in detection of hypoxic ischemic encephalopathy in neonates and can be used as initial imaging modality.
Imaging of the brain in full-term neonates: does sonography still play a role?
Pediatric Radiology, 2006
To date the literature comparing the usefulness of US and MR examinations of the neonatal brain suggests that US is not as effective a modality as MR. However, available studies were done on older equipment and published descriptions of the abnormalities found in the term brain are often incomplete. The purpose of this article is to emphasize technical factors that may be useful to optimize US imaging of the term neonatal brain, to provide a description of the sonographic findings in the brain in full-term neonates with hypoxic-ischaemic injury and to provide some data regarding the accuracy of sonography. While MR imaging may reveal abnormalities of the brain more floridly than sonography, we believe that sonography remains an extremely useful modality for evaluation of the full-term neonatal brain and it is probably a more accurate modality in this age group than the current literature suggests. Further prospective studies comparing sonographic and MR imaging findings are required to document the accuracy of sonography better and to help us define the role of this modality better. Such studies may help us select which patients really require MR imaging.
Cerebral infarction in term neonates: diagnosis by cerebral ultrasound
Child's Nervous System, 1986
Cranial ultrasound (US) through the newborn's open fontanelle can diagnose not only intracerebral hemorrhages but also diffuse and localized hypoxic-ischemic encephalopathies. Sonographically, it was possible to distinguish between different courses of cerebral ischemia in seven neonates: (1) ischemic infarction, usually in the area of the middle cerebral artery; (2) borderline infarction; (3) transient ischemia. The patients showed lateralized seizures during the first days of life with a corresponding focus in the electroencephalogram (EEG). Computed tom o g r a p h y showed areas of partially reduced density corresponding to the regions of increased echogenicity in ultrasound. The course was various; prognosis was good except in one patient. Etiologically, embolism, thromboses or hypoxemia were responsible for cerebral infarction. In some cases secondary bleeding ensued. The prognostic value of cerebral lesions was dependent on the involved area, gestational age, and any concurrent hypoxic cerebral damage.
Transcranial Ultrasound in Comparison to MRI in Evaluation of Hypoxic Ischemic Injury in Neonates
The Egyptian Journal of Hospital Medicine
Background: Hypoxic-ischemic injury is the most common cause of encephalopathy in newborns. Objectives: The goal of our study was to demonstrate the role of transcranial ultrasound (TCUS) compared to MRI in assessment of neonatal encephalopathy. Patients and methods: Consecutive thirty sex neonates with hypoxic-ischemic encephalopathy (HIE) were included. All cases had undergone MR imaging as well as transcranial ultrasound study of the brain. The study was conducted between May 2015 and September 2017. They were collected from the Neonatology Intensive Care Unit at Elsayed Galal and El-Demerdash University Hospitals. Results: Our study found that stages I and II showed mild to moderate HIE presented with peripheral pattern and white matter injuries while stage III revealed severe HIE presented with central pattern of injury (BGT). In addition, our study reported that all patients with stage III of HIE showed severe central pattern on MRI. Conclusion: MRI imaging is considered a sensitive technique in detecting different MR patterns of encephalopathy in newborns. MRI placed other imaging modalities in diagnostic assessment and early predictor of future development of neurological abnormalities in neonates with encephalopathy.
Journal of Bahria University Medical and Dental College
Introduction: Preterm birth is a common cause of neonatal mortality with an additional burden of adverse neurodevelopmental outcomes. It is caused by different factors that can be either perinatal, natal or postnatal leading to white matter injury/intracranial hemorrhages. These lesions can be readily assessed by cranial ultrasound which provides cost-effective, radiation-free, bedside imaging. Conclusion: Cranial ultrasound is an innovative method to assess brain injury in preterm infants. Ultrasonographic evaluation of preterm brain is recommended as early as possible after birth with interval follow up. Three distinct patterns of brain injury can be seen in preterm infants: Periventricular leukomalacia (PVL), Germinal Matrix-Intraventricular hemorrhage (GMH-IVH) and cerebellar hemorrhages. Germinal matrix hemorrhage is found to be most common pattern with cystic PVL being next among three patterns of brain injury. Ultrasound is an operator-dependent technique with poor visualizat...
The Egyptian Journal of Radiology and Nuclear Medicine, 2016
Objective: Neonatal encephalopathy (NE) is a condition that causes significant morbidity and mortality to the infant. The diagnosis and severity of NE rely heavily on clinical presentation and imaging findings. The present study was planned to assess the role of MRI and Transcranial ultrasound (TCUS) in the early identification of cerebral injuries in NE. Patients and methods: Our study enrolled 38 newborns presented with NE. Brain MRI and TCUS were carried out for each case and their results were compared. Results: MRI was positive in 33 cases. Findings at MRI supported hypoxic-ischemic encephalopathy as an etiology in 25 neonates, and other etiologies included metabolic disorders in 2, congenital neonatal infection in 1, 2 cases of neonatal stroke, congenital brain anomalies in 2 neonates and cerebral venous sinus thrombosis in 1. The overall diagnostic accuracy of TCUS compared to MRI was 78.9%, while the overall sensitivity and specificity were 81.8% and 60% respectively. Conclusion: TCUS is an effective screening tool in detecting the etiology of NE in suspected cases; it is sometimes crucial in critically sick neonates; however, early MRI is mandatory as it can detect precisely the extent of brain injury compared with TCUS alone.