Advanced cranial ultrasound: transfontanellar Doppler imaging in neonates

Abstract

We know that many cerebral lesions are of circulatory origin and it is now important to study cerebral hemodynamics by pulsed and color Doppler ultrasonography. The revolution in the imaging of vascular physiology, the diagnosis, and the prognostic evaluation of vascular disease are not based on morphological sonographic studies but on the Doppler techniques that can display cerebral vessels in the neonate. The results of the hemodynamic investigation in 491 newborns aged from 32 weeks of gestation to 9 months by means of pulsed and color Doppler are reported. Normal values of the resistive index, peak systolic, end-diastolic, and time-averaged velocities in seven different vessels are determined. Some pathological examples are presented. Doppler techniques play a major role in the diagnosis, follow-up, and management of brain damage, whether ischemo-hemorrhagic, infectious, or developmental or tumoral, and of pericerebral collections.

Effects of antenatal magnesium sulfate therapy on cerebral and systemic hemodynamics in preterm newborns

“…Doppler assessment of the neonatal anterior cerebral artery (ACA), as well as left and right middle cerebral arteries (LMCA and RMCA), included peak‐systolic velocity (PSV), end‐diastolic velocity (EDV), mean velocity (MV = area under the curve) and resistance index (RI = PSV−EDV/PSV) as well as the relative vascular resistance (RVR) using a Doppler ultrasonography machine (HDI 5000 SONOCT, ATL Ultrasound, Bothel, WA, USA). The transfontanellar approach described by Courture et al (10) was used for both the Doppler studies and simultaneous ultrasound brain scans for the detection of PIVH. Extension of an eventual hemorrhage was subsequently graded from 1 to 4 according to Papile et al (11).…”

Mirror‐image artifact mimicking epidural hematoma: Usefulness of power doppler sonography

“…5 By demonstrating cortical views, color Doppler sonography can effectively differentiate between enlargement of the subarachnoid space and a subdural collection. 6 In our case, the curved calvarium generated a mirror image of the cephalhematomas on sonography, an artifact that mimicked the appearance of epidural hematoma.…”

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

“…This may be considered a strength compared with conventional ultrasound where assessment of cerebral circulation is mainly based on measurements in large vessels. 11,12 Our preliminary experience indicates that following a trend over time may be more clinically relevant than conventional snapshot velocity measurements in one specified artery to assess cerebral circulation. Finally, NeoDoppler appeared to be clinically feasible and well tolerated as a non-invasive, bedside tool for continuous monitoring.…”