High resolution ultrasound of the neonatal brain

Objectives: Ultrasound of the brain became an easy and little burdening standard investigation during last decades. The technique was developed and additional options were introduced (i.e., Power-Doppler, Sono-CT, 3D-Ultrasound). What are the consequences?

Material and Methods: From 1997–2003 the brains of approximate 2500 newborns were examined by means of a “high end“-ultrasound system and high-frequency scanheads ≥7MHz in the neonatal intensive care units of the FU Berlin.

Results: Subdural and subarachnoidal bleedings were not detected by ultrasound in spite of selective screening. Frequently, it is impossible to graduate the intracerebral hemorrhage exactly in spite of two classifications. The transient periventricular increasing in echo is an unsolved problem of etiology and prognosis. Normal sonographic findings don't exclude cerebral palsy in older children. Particulary by means of a 12MHz-linear-scanhead it's possible to differentiate between subependymal pseudocysts near the Foramen Monroi and a frontal variant of plexuscysts. Subependymal pseudocysts lateral of the frontal horn are harmless effects of germinolysis in mature infants and must be distinguished from ventricular bands after ventriculitis. 3D-Ultrasound mostly produced no additional informations.

Conclusions: The development of the ultrasound technique facilitates information profit, but, experience and supervision are necessary The conscious look at picture sides is important. Nevertheless not all pathological findings are seen. The classification of intracerebral hemorrhage should be adapted to technical possibilities and revised. Particulary as the intracerebral hemorrhage still is one of the unsolved problems in neonatology.