Neonatal Cranial Ultrasonography: Guidelines Fo...
Ultrasound can lead to thermal and mechanical effects in interrogated tissues. We reviewed the literature to explore the evidence on ultrasound heating on fetal and neonatal neural tissue. The results of animal studies have suggested that ultrasound exposure of the fetal or neonatal brain may lead to a significant temperature elevation at the bone-brain interface above current recommended safety thresholds. Temperature increases between 4.3 and 5.6C have been recorded. Such temperature elevations can potentially affect neuronal structure and function and may also affect behavioral and cognitive function, such as memory and learning. However, the majority of these studies were carried out more than 25 y ago using non-diagnostic equipment with power outputs much lower than those of modern machines. New studies to address the safety issues of cranial ultrasound are imperative to provide current clinical guidelines and safety recommendations.
Neonatal Cranial Ultrasonography: Guidelines fo...
For the present analysis, we acquired data from the population-based prospective birth cohort study, SNiP, from 2002 to 2008 collecting data about morbidity and mortality of newborns and their mothers in a predefined region yielding to data about prevalence, risk factors and confounders for/of neonatal diseases. Based on this, cranial ultrasound was used to assess potential cerebral disorders. Physicians trained for this study collected data on newborn children and their mothers, regarding neonatal health, morbidity, and mortality. We calculated the prevalence rates for major neonatal diseases, risk factors, and confounding conditions, on a cross-sectional, prospective basis. All mothers with a complete data set were included, and they provided written informed consent to participate in the study.
The EurUS.brain Group is a group of European neonatologists with a special interest in neonatal cranial ultrasound (CUS) and neonatal neurology. It is nested within the Brain, Development & Imaging section of the European Society for Paediatric Research (ESPR).
Formal ultrasound teaching by and for neonatologists, as well as setting standards and formulating guidelines, is an imperative in a context where neonatologists are widely using bedside CUS as the first-line imaging technique to study the neonatal brain.
The aim of the basic EurUS.brain neonatal CUS course is to convey basic knowledge on cranial ultrasound in the preterm and term neonate. The course will introduce you to the ultrasound and doppler ultrasound technique, present the standard views that should be obtained, and teach you how to optimise your scanning settings to obtain the best possible images.
The course is targeted towards neonatal unit staff aiming at performing bedside neonatal cerebral ultrasound scanning at an advanced level, incl. pediatricians, neonatologists, radiologists and other specialists with a special interest in neonatal neurology and neuroimaging. It is aimed at those who are already experienced in performing bedside neonatal cranial ultrasonography and want to take their knowledge and skills to an expert level.
US is highly reliable in the detection of cystic WM injury (PVL grade II or more), but has significant limitations in the demonstration of noncystic WM injury (PVL grade I). This deficiency of neonatal cranial US is important, because noncystic WM injury is considerably more common than cystic WM injury.
Preterm and sick newborn infants are at risk of brain injury. Neuroimaging has been extensively used in the evaluation of the neonatal brain, with cranial ultrasound being the most widely used neuroimaging method as it is able to detect major intracranial abnormalities.
Hypoxic ischemic encephalopathy (HIE) is a major cause of mortality and morbidity in neonates. Malondialdehyde (MDH) is a colorless lipid that can be used as a marker for oxidative stress. Cranial ultrasound sensitivity and specificity in detection of neonatal HIE ought to be further investigated. This study aims to detect whether serum (MDH) can be used as an indicator for HIE severity and to assess the role of cranial ultrasound in diagnosis of HIE neurological disorders, correlating ultrasound findings to MDA levels.
Arie Franco, Kristopher Neal Lewis Department of Radiology, Medical College of Georgia at Georgia Regents University, Augusta, GA, USA Abstract: 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 high-resolution 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. Keywords: ultrasound, cranial, neonatal, infants, preterm infants, intracranial hemorrhage, periventricular leukomalacia
It is of high incidence of brain injuries in premature infants, so it is necessary to diagnose and treat the brain injury early for neonatal clinical practice. We are aimed to investigate the relationship between early postnatal cranial ultrasonography and psychomotor and mental development in prematrue infants at the age of 12 months.
Abstract: Neonatal bacterial meningitis is a common manifestation of late onset neonatal sepsis. Cranial sonography (CRS) has a crucial role in assessment of infants with clinical suspicion of bacterial meningitis as well as follows up of its complications. CRS is performed with high frequency transducer through anterior fontanelle in both coronal and sagittal planes. Various sonographic findings range from echogenic and widened sulci, ventriculomegaly, ventriculitis, hydrocephalus, extra-axial fluid collections, cerebritis and brain abscess. Sonography is extremely beneficial in evaluating intraventricular contents, especially debris and intraventricular septations. Linear high frequency probe along with color Doppler interrogation are of utmost importance in evaluating extra-axial fluid collection and helps differentiating it from benign subarachnoid space enlargement. Due to low cost, easy portability, speed of imaging, no need for sedation and above all lack of ionizing radiation make it superior to other cross sectional imaging, like CT and MRI, in evaluation of these sick neonates. Apart from textbooks, there is paucity of recently available literature on cranial sonographic findings in neonatal meningitis. This article is written with an educational intent to review the spectrum of findings in neonatal meningitis, with stress on findings that will be beneficial in the clinical practice.
It has been well demonstrated that enlarging head circumference is an insensitive sign of hydrocephalus in the premature infant. Ventricular dilatation after neonatal intracranial hemorrhage probably begins soon after the hemorrhage in many infants and pre-dates the increase in the rate of head growth by days to weeks. Infants with hydrocephalus have a poor prognosis, and one important factor in their outcome may be a delay in the detection and treatment of hydrocephalus.
Premature babies are especially vulnerable to certain conditions involving the brain. These include intraventricular haemorrhage (IVH), which often occurs during the first few days,[2] and periventricular leukomalacia (PVL), which tends to occur later on.[3] One of the main purposes of routine cranial ultrasound scanning in neonatal units is to identify these problems as they develop. If severe intraventricular haemorrhage is noted then the baby will need to be scanned more frequently in case post-haemorrhagic hydrocephalus (swelling of the ventricles as the natural flow of the cerebrospinal fluid is blocked by blood-clots) develops.[4]
Most neonatal units in the developed world routinely perform serial cranial ultrasound scans on babies who are born significantly premature. A typical regimen might involve performing a scan on the first, third and seventh day of a premature baby's life, and then at regular intervals until the baby reaches term.[6]
Background: The survival of asphyxiated neonates has significantly increased in recent years because of numerous advancements in contemporary neonatal intensive care. The most popular and easily repeatable imaging method for the neonatal brain, the neurosonogram can demonstrate the most common types of cerebral injury in preterms and term infants. This study aims to analyse the value of cranial ultrasonography as an investigative tool for birth asphyxia babies (>34 weeks) will be evaluated to learn the morphology of various cerebral lesions and to compare clinical findings with neurosonogram results. 041b061a72