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Neonatal cranial sonography: A concise review for clinicians.

Gupta P, Sodhi KS, Saxena AK, Khandelwal N, Singhi P - J Pediatr Neurosci (2016 Jan-Mar)

Bottom Line: Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage.Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation.Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage. Not withstanding this, cranial sonography has yielded results for a repertoire of indications. Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation. Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma. In this review, we discuss the technique, normal and variant anatomy as well as disease entities of neonatal cranial sonography.

No MeSH data available.


Related in: MedlinePlus

Periventricular leukomalacia. (a) Coronal image shows marked periventricular echogenities in bilateral parietal location, finding suggestive of periventricular leukomalacia. (b) Multiple cystic lesions in the periventricular location are seen on coronal image as a manifestation of cystic periventricular leukomalacia
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Figure 6: Periventricular leukomalacia. (a) Coronal image shows marked periventricular echogenities in bilateral parietal location, finding suggestive of periventricular leukomalacia. (b) Multiple cystic lesions in the periventricular location are seen on coronal image as a manifestation of cystic periventricular leukomalacia

Mentions: PVL represents an ischemic injury involving the watershed area of the preterm brain, i.e., the periventricular white matter. There is no accurate way to diagnose PVL in the acute phase. Sonography is the best available imaging modality though it also remains fairly insensitive in early cases. Findings include focal areas of increased echogenicity in the superolateral periventricular areas, most prominent at the level of the atria [Figure 6a]. Pitfall already mentioned in this context is the normal periventricular flare due to anisotropic effect. Mild cases of PVL can resolve on follow-up sonography. Chronic PVL results in ventriculomegaly, periventricular cystic change, and loss of deep white matter, with the sulci approximating the ventricular wall [Figure 6b]. MRI has a better sensitivity and specificity in chronic PVL.


Neonatal cranial sonography: A concise review for clinicians.

Gupta P, Sodhi KS, Saxena AK, Khandelwal N, Singhi P - J Pediatr Neurosci (2016 Jan-Mar)

Periventricular leukomalacia. (a) Coronal image shows marked periventricular echogenities in bilateral parietal location, finding suggestive of periventricular leukomalacia. (b) Multiple cystic lesions in the periventricular location are seen on coronal image as a manifestation of cystic periventricular leukomalacia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4862295&req=5

Figure 6: Periventricular leukomalacia. (a) Coronal image shows marked periventricular echogenities in bilateral parietal location, finding suggestive of periventricular leukomalacia. (b) Multiple cystic lesions in the periventricular location are seen on coronal image as a manifestation of cystic periventricular leukomalacia
Mentions: PVL represents an ischemic injury involving the watershed area of the preterm brain, i.e., the periventricular white matter. There is no accurate way to diagnose PVL in the acute phase. Sonography is the best available imaging modality though it also remains fairly insensitive in early cases. Findings include focal areas of increased echogenicity in the superolateral periventricular areas, most prominent at the level of the atria [Figure 6a]. Pitfall already mentioned in this context is the normal periventricular flare due to anisotropic effect. Mild cases of PVL can resolve on follow-up sonography. Chronic PVL results in ventriculomegaly, periventricular cystic change, and loss of deep white matter, with the sulci approximating the ventricular wall [Figure 6b]. MRI has a better sensitivity and specificity in chronic PVL.

Bottom Line: Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage.Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation.Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage. Not withstanding this, cranial sonography has yielded results for a repertoire of indications. Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation. Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma. In this review, we discuss the technique, normal and variant anatomy as well as disease entities of neonatal cranial sonography.

No MeSH data available.


Related in: MedlinePlus