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Pediatric Imaging

E2297. Neonatal Cranial Sonography: An Approach to Accurate Diagnosis

Mohabir A,  Assaad P. Long Island Jewish Medical Center, Queens, NY

Address correspondence to A. MOHABIR (ANTHONYMOHABIR@GMAIL.COM)

Background Information: For the experienced radiologist, neonatal cranial sonography is a valuable tool. Unfortunately, not many radiologists are exposed to these examinations. This presentation is a primer to the practice of cranial sonography. Anatomic detail on standard sonographic projections are reviewed. Cases encompassing a breadth of pathology on ultrasound are supported with CT and MRI correlations. Upon completion of this presentation the radiologist will have a greater understanding of the utility of cranial sonography and the benefits to the neonate.

Educational Goals/Teaching Points: This exhibit presents imaging techniques, anatomy review, interesting cases of germinal matrix hemorrhage, meningitis, periventricular leukomalacia, agenesis of the corpus callosum, Dandy Walker, velum interpositum cyst, and hydrocephalus.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We will review ultrasound probe selection, standard sonographic views, and the benefits and pitfalls of each projection. Subsequently, we review intracranial anatomy with specific attention to the intraaxial versus extraaxial spaces, ventricles, choroid plexus, caudothalamic groove, and periventricular white matter. Various cranial ultrasound cases are discussed with MRI and CT correlates. These cases include germinal matrix hemorrhage, meningitis, periventricular leukomalacia, agenesis of the corpus callosum, Dandy Walker, velum interpositum cyst, and hydrocephalus.

Conclusion: High-resolution transfontanellar cranial sonography provides a plethora of information regarding intracranial pathology. This technique is simply performed, uses no ionizing radiation, does not require pediatric sedation, and is cheaper and quicker than obtaining MRI or CT. Neonates with acute or congenital pathology can be initially diagnosed with cranial sonography as well as continuously followed. Review of the sonographic technique and the most common critical diagnoses will aid the practicing radiologist in obtaining an accurate diagnosis.