Document Detail

Sonographic biometry of the frontal lobe in normal and growth-restricted neonates.
MedLine Citation:
PMID:  14739353     Owner:  NLM     Status:  MEDLINE    
Assessing the impact of restricted intrauterine growth on neonatal frontal lobe (FL) dimensions is important. We aimed to create a sonographic nomogram of FL dimensions in neonates at different gestational ages (GA) and evaluate the impact of small head circumference (HC) on FL dimensions. We conducted sonographic biometry of the FL at birth. We included 218 newborn infants born at GA of 24-43 wk: appropriate for GA and normal HC (n = 178), and small for GA and small HC (n = 23). Infants with a 5-min Apgar score <7, severe congenital malformations, or chromosomal abnormalities were excluded. Through a coronal ultrasound scan via the anterior fontanelle at the level where the most lateral point of the left Sylvian fissure was best demonstrated, we drew a triangle connecting the most lateral point of the Sylvian fissure, the corpus callosum, and the subcalvarian point of the interhemispheric fissure. We measured the three sides of the triangle, Sylvian-fontanellar distance, Sylvian-callosal distance, and fontanellar-callosal distance, and calculated the frontal triangular area. All four FL dimensions increased significantly between 24 and 43 wk of gestation in both appropriate for GA-normal HC and small for GA-small HC neonates, and were strongly correlated with HC and birth weight. Regression lines of GA against Sylvian-fontanellar distance, Sylvian-callosal distance, fontanellar-callosal distance, and frontal triangular area in the appropriate for GA-normal HC group differed significantly from those of the small for GA-small HC group (p < 0.05). Male neonates had significantly larger Sylvian-fontanellar and Sylvian-callosal distances than females (p < 0.01 and p < 0.015, respectively). In conclusion, FL measures increased significantly between 24 and 43 wk of gestation, and were strongly correlated with HC. We speculate that a sonographically small fetal HC implies growth restriction of the fetal FL.
Imad R Makhoul; Michalle Soudack; Israel Goldstein; Tatiana Smolkin; Ada Tamir; Polo Sujov
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Publication Detail:
Type:  Journal Article     Date:  2004-01-22
Journal Detail:
Title:  Pediatric research     Volume:  55     ISSN:  0031-3998     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-21     Completed Date:  2004-11-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  877-83     Citation Subset:  IM    
Department of Neonatology, Meyer Childrens Hospital, Rambam Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Bat-Galim, Haifa 31096, Israel.
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MeSH Terms
Age Factors
Apgar Score
Biometry / methods*
Birth Weight
Brain / anatomy & histology,  pathology*
Fetal Growth Retardation / pathology
Frontal Lobe / pathology*,  ultrasonography*
Gestational Age
Infant, Newborn
Infant, Small for Gestational Age
Linear Models
Time Factors
Ultrasonography, Prenatal

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