Role of Trans-cranial Ultrasonography and Color Doppler in Diagnosis and Grading of Neonatal Hypoxic–Ischemic Encephalopathy

Abstract

Objective: To evaluate the role of trans-cranial ultrasound and trans-cranial Doppler of the anterior and middle cerebral arteries in diagnosis and grading of hypoxic ischemic encephalopathy (HIE). Methods:The study was conducted on 26 cases and 26 controls in the neonatal intensive care unit incubator of Al-Salam Hospital and at Al-Nasr hospital in Port Said governorate in Egypt. Each patient was subjected to full history taking, clinical examination, and transcranial ultrasound examination e.g., anterior cerebral artery and middle cerebral artery blood flow parameters using color Doppler flow image (CDFI), color Doppler energy (CDE), pulsed wave Doppler and measuring RI of both arteries. Results:In 26 cases and 26 controls, there was statistically significant negative correlation between MCA RI and presence of HIE, and Apgar score. There was statistically significant positive correlation between MCA RI and both periventricular leukomalacia, and Periventricular leukomalacia grade.There was statistically significant negative correlation between ACA RI and presence of HIE, and Apgar score, and statistically significant positive correlation between ACA RI and both of periventricular leukomalacia, periventricular leukomalacia grade, and Sarnat stages of HIE.The mean right-side MCA, left-side MCA, and mean average MCA in control group were statistically significantly higher than the study group. Conclusion:The newborn brain can be evaluated with trans-cranial ultrasonography and transcranial Doppler. For displaying the most typical types of cerebral damage in preterm neonates, gauging the lesion's progression, and monitoring brain growth, they are safe and reliable approaches. Early transcranial Doppler ultrasonography should be performed on neonates with HIE to predict the course of their clinical treatment.