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Diagnostic ultrasound ( PDFDrive )

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PART FIVE: Pediatric Sonography

CHAPTER

45

Neonatal and Infant Brain Imaging

Carol M. Rumack and Amanda K. Auckland

SUMMARY OF KEY POINTS

• Brain ultrasound of premature infants is best performed for

germinal matrix hemorrhage and hydrocephalus at 10 to 14

days of life and for cystic periventricular leukomalacia at 30

days of life.

• The best time to assess for white matter injury of

prematurity is at term-equivalent age.

• Cerebellar hemorrhage is missed if mastoid views of the

posterior fossa are not obtained.

• High-resolution images are needed to fully study the brain

parenchyma for white matter injury.

• Multiple acoustic windows are essential for accurate

detailed ultrasound imaging of the brain.

• Doppler evaluation is key for any cystic lesion to exclude

vascular malformations.

• Computed tomography of the newborn brain is not

indicated except in the case of a traumatic birth.

• Congenital anomalies are well evaluated with ultrasound

and, if further information is needed, are an indication for

magnetic resonance imaging.

CHAPTER OUTLINE

EQUIPMENT

SONOGRAPHIC TECHNIQUE

Coronal Imaging

Sagittal Imaging

Posterior Fontanelle Imaging

Mastoid Fontanelle Imaging

Three-Dimensional Ultrasound

STANDARDIZED REPORTS

Standardized Views for Display

DEVELOPMENTAL ANATOMY

Brain Sulcal Development and

Subarachnoid Spaces

Cavum Septi Pellucidi and Cavum

Vergae

Cavum Veli Interpositi

Frontal Horn Variants

Choroid Plexus and Variants

Germinal Matrix

Calcar Avis

Cerebellar Vermis

Cisterna Magna

CONGENITAL BRAIN

MALFORMATIONS

DISORDERS OF NEURAL TUBE

CLOSURE

Chiari Malformations

Agenesis of Corpus Callosum

Corpus Callosum Lipoma

Dandy-Walker Spectrum

DISORDERS OF DIVERTICULATION

AND CLEAVAGE:

HOLOPROSENCEPHALY

Septo-Optic Dysplasia

Alobar Holoprosencephaly

Semilobar Holoprosencephaly

Lobar Holoprosencephaly

Middle Interhemispheric Form of

Holoprosencephaly

DISORDERS OF SULCATION AND

CELLULAR MIGRATION

Schizencephaly

Lissencephaly

DESTRUCTIVE LESIONS

Porencephalic Cyst

Hydranencephaly

Cystic Encephalomalacia

Metabolic Disorders

HYDROCEPHALUS

Cerebrospinal Fluid Production and

Circulation

Level of Obstruction

HYPOXIC-ISCHEMIC EVENTS

Arterial Watershed Determines

Regional Pattern of Brain Damage

Germinal Matrix Hemorrhage

Subependymal Hemorrhage (Grade I

Hemorrhage)

Intraventricular Hemorrhage (Grade II

Hemorrhage)

Intraventricular Hemorrhage With

Hydrocephalus (Grade III

Hemorrhage)

Intraparenchymal Hemorrhage (Grade

IV Hemorrhage)

Cerebellar Hemorrhage

Subarachnoid Hemorrhage

Cerebral Edema and Infarction

White Matter Injury of Prematurity

or Periventricular Leukomalacia

Term Infants With Hypoxic Ischemic

Injury

Focal Infarction

Lenticulostriate Vasculopathy

Hyperechoic Caudate Nuclei

POSTTRAUMATIC INJURY

Subdural and Epidural Hematomas

INFECTION

Congenital Infections

Neonatal Acquired Infections

Meningitis and Ventriculitis

INTRACRANIAL MASSES

Brain Tumors

Cystic Intracranial Lesions

Arachnoid Cysts

Porencephalic Cysts

Choroid Plexus Cysts

Supratentorial Periventricular Cystic

Lesions

Frontal Horn Cysts

Subependymal Cysts

Periventricular Leukomalacia

Galenic Venous Malformations

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