Document Detail

Posterior fontanelle sonography: an acoustic window into the neonatal brain.
MedLine Citation:
PMID:  15313724     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Sonographic brain studies are classically performed through the anterior fontanelle, but visualization of posterior supratentorial and infratentorial structures is poor with this approach. Posterior fontanelle sonography is recommended for better assessment of these structures. Our purpose was 1) to determine whether sonography of the brain through the posterior fontanelle (PF) improves visualization of brain lesions when added to the routine anterior fontanelle (AF) approach and 2) to describe standardized PF coronal and sagittal sections. METHODS: In this prospective study (conducted from February 1999 to January 2001), PF sonography was added to AF sonography in 165 consecutive premature neonates with a birth weight of < 2000 g. Sonograms were recorded in digital format for re-evaluation at the end of the study. Lesions were grouped as congenital, infectious, hemorrhagic, or hypoxic-ischemic. The chi2 test for paired data and the kappa coefficient were used to compare diagnoses with AF alone and diagnoses with AF plus PF. RESULTS: PF sonography was performed in 164 of 165 patients. Results were normal in 86 and abnormal in 78. The single posterior fossa malformation detected in this series was best delineated with the PF approach. PF sonography increased the diagnostic rate of grade II hemorrhage by 32%. Cerebellar hemorrhage (two patients) and cerebellar abscesses (one patient) were diagnosed by using the PF approach. PF sonography did not contribute to the diagnosis of periventricular leukomalacia. CONCLUSION: Study of the neonatal brain with the addition of PF sonography afforded greater accuracy in detecting intraventricular hemorrhage compared with AF sonography alone, especially when the ventricle was not dilated. The PF approach better defines posterior fossa malformations.
Flavia Correa; Goya Enríquez; José Rosselló; Javier Lucaya; Joaquim Piqueras; Celestino Aso; Elida Vázquez; Arantxa Ortega; Alfredo Gallart
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  25     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-17     Completed Date:  2004-09-16     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1274-82     Citation Subset:  IM    
Departments of Pediatric Radiology, Vall d'Hebron Hospital, Barcelona, Spain.
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MeSH Terms
Brain Abscess / congenital,  ultrasonography
Brain Damage, Chronic / congenital*,  ultrasonography*
Brain Stem / abnormalities*,  ultrasonography*
Cerebellar Diseases / congenital*,  ultrasonography*
Cranial Fossa, Posterior / abnormalities,  ultrasonography
Cranial Sutures / ultrasonography
Diagnosis, Differential
Echoencephalography / instrumentation*
Hypoxia, Brain / congenital,  ultrasonography
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases / ultrasonography*
Intracranial Hemorrhages / congenital,  ultrasonography
Leukomalacia, Periventricular / ultrasonography
Meningitis, Bacterial / congenital,  ultrasonography
Neonatal Screening / instrumentation
Prospective Studies
Sensitivity and Specificity

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