State-of-the-Art Cranial Sonography: Part 2, Pitfalls and Variants

Lowe, Lisa H.; Bailey, Zachary

doi:10.2214/ajr.10.6203

Cited by 27 publications

(28 citation statements)

References 34 publications

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“…Also, these hyperechoic pseudolesions and halos are less echogenic than the adjacent choroid plexus. 7,32,33 One well documented example is the thalamic pseudolesion, a hyperechoic focus in the thalamus with the appearance of a central thalamic hemorrhage seen when imaging through the posterior fontanel. The hyperechoic focus is no longer seen when imaging through the anterior fontanel.…”

mentioning

confidence: 99%

Neonatal cranial ultrasound: current perspectives

Franco¹,

Lewis²

2013

RMI

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Ultrasound is the most common imaging tool used in the neonatal intensive care unit. It is portable, readily available, and can be used at bedside. It is the least expensive cross sectional imaging modality and the safest imaging device used in the pediatric population due to its lack of ionizing radiation. There are well established indications for cranial ultrasound in many neonatal patient groups including preterm infants and term infants with birth asphyxia, seizures, congenital infections, etc. Cranial ultrasound is performed with basic grayscale imaging, using a linear array or sector transducer via the anterior fontanel in the coronal and sagittal planes. Additional images can be obtained through the posterior fontanel in preterm newborns. The mastoid fontanel can be used for assessment of the posterior fossa. Doppler images may be obtained for screening of the vascular structures. The normal sonographic neonatal cranial anatomy and normal variants are discussed. The most common pathological findings in preterm newborns, such as germinal matrix-intraventricular hemorrhage and periventricular leukomalacia, are described as well as congenital abnormalities such as holoprosencephaly and agenesis of the corpus callosum. New advances in sonographic equipment enable highresolution and three-dimensional images, which facilitate obtaining very accurate measurements of various anatomic structures such as the ventricles, the corpus callosum, and the cerebellar vermis. Limited studies have been performed to predict that longitudinal measurements of these anatomic structures might predict the clinical outcome of high-risk preterm newborns. Hemodynamic Doppler studies may offer the potential for early intervention and treatment to counter the hazards of developmental delay and a moribund clinical outcome.

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confidence: 99%

Neonatal cranial ultrasound: current perspectives

Franco¹,

Lewis²

2013

RMI

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“…Although reference charts of normal ventricular sizes are available, the morphology of the ventricles may be the best determinant of ventriculomegaly. 40,84 Although beyond the scope of the current review and not specifically discussed, in the detection of IVH, the use of alternate acoustic windows, such as the posterior fontanelle or the mastoid fontanelle, may increase the detection rate, particularly of grade II IVH, which may be present only in the occipital horns. 35,85 Callosal Abnormalities Abnormalities of the corpus callosum have received little attention in relation to NE, or more specifically HII, although regional or global callosal thinning is a well-known late finding in perinatal brain injury.…”

Section: Ventricular Sizementioning

confidence: 99%

“…[32][33][34] In describing lesser-known US findings in NE, either due to HII or other causes, we reinforce the significant role US can play as a first-line imaging tool, which can be indispensable during the evaluation of critically ill neonates or can complement magnetic resonance imaging (MRI) in more stable neonates. [35][36][37][38][39][40][41] This imaging update draws heavily on the experience of Epelman et al, 39 whose 29-month experience with a cohort of patients with NE receiving concurrent US and MRI guides this discussion. The study advocates high-quality, real-time evaluation with linear, high-resolution transducers.…”

Section: Figurementioning

confidence: 99%

Easily Overlooked Sonographic Findings in the Evaluation of Neonatal Encephalopathy: Lessons Learned From Magnetic Resonance Imaging

Dinan

Daneman

Guimaraes

et al. 2014

Seminars in Ultrasound, CT and MRI

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“…Mild ventricular asymmetry is considered to be a normal variantwhich has been described in up to 90% of normal newborn infants [1,3,4]. It has been reported that the larger ventricle is more commonly on the left side [5].…”

Section: Normal Ventriclesmentioning

confidence: 99%

Neonatal head ultrasound: systematic approach to congenital Central Nervous System anomalies. A pictorial essay.

Yoon

Cho

2016

Med Ultrason

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Brain ultrasound is widely used for the screening of prematurely born babies. Although the best imaging modality for the central nervous system anomaly is brain MRI, the first imaging study in the post-natal period is brain ultrasonography in most cases. Anomalies could be found incidentally on screening ultrasound, or in those cases already suspected on prenatal ultrasound. In order not to miss congenital structural abnormalities of the brain on screening ultrasound, systematic approaches would be very helpful. The ventricles and sylvian fissures are very important structures to suspect central nervous system anomalies: they are symmetric structures so we should look for any asymmetry or maldevelopment. And then, on sagittal images, the midline structures including the corpus callosum and cerebellar vermis should be observed carefully. Finally, we should look for any abnormality in gyration or cortical development. Skull defect with herniation of intracranial contents, a spectrum of encephalomeningocele, could be alsoidentified on ultrasound. Congenital infections such as cytomegalovirus infectionmay showventriculomegaly and malformation of the cortical development on imaging studies.

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State-of-the-Art Cranial Sonography: Part 2, Pitfalls and Variants

Abstract: In this part of the article, we will describe pitfalls and variants that may be confused with pathologic abnormalities. Emphasis will be placed on recognizing normal variations and distinguishing them from pathologic abnormalities that may require additional imaging or clinical follow-up.

Cited by 27 publications

References 34 publications

Neonatal cranial ultrasound: current perspectives

Neonatal cranial ultrasound: current perspectives

Easily Overlooked Sonographic Findings in the Evaluation of Neonatal Encephalopathy: Lessons Learned From Magnetic Resonance Imaging

Neonatal head ultrasound: systematic approach to congenital Central Nervous System anomalies. A pictorial essay.

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