Transcranial and pulsed focused ultrasound that activates ...
Neonatal transcranial ultrasound
-
Upload
ahmed-bahnassy -
Category
Health & Medicine
-
view
3.247 -
download
2
description
Transcript of Neonatal transcranial ultrasound
Neonatal transcranial ultrasound...The normal ,and
abnormal .
Dr/Ahmed BahnassyConsultant Radiologist
PSMMC
Technical considerations
1.choosing the probe.2.adjusting depth and
focus.3.adjusting gain.4.right and left labelling.5.planes consideration.6.use of previous scans
for moving heads
Planes and landmarks
coronal
sagittal
Coronal scan 1
Coronal scan 2
Coronal scan 3
Coronal scan 4
Coronal 5
Importance of standardizing scans
Brain diagram showing a coronal view as seen in ultrasound by greater fontanel. this explain some usefull measurements for ultrasound in neonatal brain: 1- Lateral ventricle (posterior horn): normal ≤ 13mm 2 - Third ventricle: normal ≤ 10mm 3 - Interhemispheric fissure: normal ≤ 6mm 4 - Subarachnoid space ≤ 4mm
Midline sagittal
Para-sagittal 1
Para-sagittal 2
Para-sagittal 3
Other imaging planes
Germinal matrix
Highly vascular structure that gives rise to nerve cells.Just above the caudothalamic groove and beneath ependymal lining of ventricles.Begins to involute at 3rd month of gestation and complete by 36 week.Source of bleeding in premature infants.
Germinal matrix haemorhage(acute)
Resolving haemorhage
Grades II and III
Grade IV
According to van Wezel et al.
• Grade 0: normal echogenicity of the periventricular white matter ( less than that of the choroid plexus)
• Grade 1: moderately increased echogenicity of the periventricular white matter, the affected region being almost as bright or as bright as the choroid plexus .
• Grade 2: seriously increased echogenicity, the affected region being obviously brighter than the choroid plexus ....
Separate notation: homogeneous, non-homogeneous .
Periventricular echogenicity
Periventricular leukomalacia
Subarachnoid and subdural collections
Ischaemic injury• Hyperechogenic areas in
thalamus .caudate nucleus...watershed areas.
Low RICompensatory mechanism.
Abnormal (cyst )!!
Using doppler
Posterior fossa abnormality
Arnold Chiari malformation Dandy walker complex
Missing structure 1
normal
Missing structure 2
normal
Missing structure 3
normal
abnormal (canal )
abnormal echogenic shadows.
Structure too large