Diagnostic ultrasound ( PDFDrive )

CHAPTER 46 Duplex Sonography of the Neonatal and Infant Brain 1575
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C
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G
FIG. 46.1 Normal Color Flow Doppler Sonogram of Cerebral Arteries and
Veins. (A) Sagittal midline scan with infant facing left shows the distal tip of the
internal carotid artery, the anterior cerebral artery, the pericallosal artery, the internal
cerebral vein, and the vein of Galen. The inferior sagittal sinus and distal pericallosal
artery are often superimposed and cannot be resolved as separate vessels. (B)
Sagittal and coronal magniied views of the superior sagittal sinus show multiple
supericial, cortical veins crossing the subarachnoid space to drain into the superior
sagittal sinus. The spectral tracing reveals steady venous low within the superior
sagittal sinus with minimal referred cardiac pulsations. (C) Coronal scan shows the
distal internal carotid arteries, middle cerebral arteries, anterior communication artery
and proximal anterior cerebral arteries. The inferior sagittal sinus and pericallosal
artery are superimposed on each other. (D) Axial view through the temporal bone
of the circle of Willis shows the opposite low direction within the near ield compared
with the far ield middle and posterior cerebral arteries. (E) Axial view through the
right mastoid fontanel shows the right transverse sinus. (F) Coronal views with a
suboccipital approach show the straight sinus and the bilateral transverse sinuses.
(G) Coronal view through the posterior fontanel shows the straight sinus and the
bilateral transverse sinuses. (H) Normal Doppler waveform produced by the central
retinal artery and the central retinal vein (H courtesy of Dr. Rebecca Riggs, The
Johns Hopkins Hospital, Baltimore, MD).