Mastoid fontanelle approach for sonographic imaging of the neonatal brain

Enríquez, Goya; Correa, F.; Aso, Celestino; Carreño, Juan Carlos Solares; González, Raúl; Padilla, Nelly; Vázquez, Élida

doi:10.1007/s00247-006-0144-z

Cited by 49 publications

(35 citation statements)

References 20 publications

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“…At least two slices should be performed, depicting the cerebral peduncles, the vermis, the cerebellar hemispheres, the fourth ventricle, the quadrigeminal plate and the cisterna magna [20]. The posterior fontanelle may be used to better visualize the occipital lobes and occipital horns and to distinguish between a prominent choroid plexus and a small intraventricular haemorrhage [1].…”

Section: How Do We Perform Us?mentioning

confidence: 99%

The rationale for routine cerebral ultrasound in premature infants

Argyropoulou

Veyrac

2015

Pediatr Radiol

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Section: How Do We Perform Us?mentioning

confidence: 99%

The rationale for routine cerebral ultrasound in premature infants

Argyropoulou

Veyrac

2015

Pediatr Radiol

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“…Examples of these supplemental acoustic windows are the lambdoid (posterior), mastoid and lateral (temporal) fontanels. So far, however, only few NICUs use these additional acoustic windows routinely [2][3][4][5] . Doppler techniques can be used for screening patency of intracranial vessels.…”

Section: Introductionmentioning

confidence: 99%

State of the Art Cranial Ultrasound Imaging in Neonates

Ecury-Goossen

Camfferman

Leijser

et al. 2015

JoVE

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Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal intensive care units, these possibilities are not optimally used. We present a comprehensive approach for neonatal CUS, focusing on optimal settings, different probes, multiple acoustic windows and Doppler techniques. This approach is suited for both routine clinical practice and research purposes. In a live demonstration, we show how this technique is performed in the neonatal intensive care unit. Using optimal settings and probes allows for better imaging quality and improves the diagnostic value of CUS in experienced hands. Traditionally, images are obtained through the anterior fontanel. Use of supplemental acoustic windows (lambdoid, mastoid, and lateral fontanels) improves detection of brain injury. Adding Doppler studies allows screening of patency of large intracranial arteries and veins. Flow velocities and indices can be obtained. Doppler CUS offers the possibility of detecting cerebral sinovenous thrombosis at an early stage, creating a window for therapeutic intervention prior to thrombosis-induced tissue damage. Equipment, data storage and safety aspects are also addressed. Video LinkThe video component of this article can be found at

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“…In addition, the echogenic tentorium and vermis may impede visualization. The mastoid fontanelle (MF) enables a better view of the PF [10][11][12]. A previous study [13] demonstrated that addition of MF views in preterm infants improved detection of cerebellar injury as compared to CUS with only AF views.…”

Section: Introductionmentioning

confidence: 99%

Posterior fossa abnormalities in high-risk term infants: Comparison of ultrasound and MRI

et al. 2013

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Objectives We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. Methods In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Results Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. Conclusions PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. Key Points • Posterior fossa abnormalities are a frequent finding in highrisk term infants.• Adding mastoid fontanelle views improves ultrasound detection of clinically relevant abnormalities.• Hypoxic-ischemic injury and small posterior fossa haemorrhages are better detected with MRI.• Cranial ultrasound examination should include mastoid fontanelle views in high-risk term neonates.

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Mastoid fontanelle approach for sonographic imaging of the neonatal brain

Cited by 49 publications

References 20 publications

The rationale for routine cerebral ultrasound in premature infants

The rationale for routine cerebral ultrasound in premature infants

State of the Art Cranial Ultrasound Imaging in Neonates

Posterior fossa abnormalities in high-risk term infants: Comparison of ultrasound and MRI

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