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Extra info for Neonatal Cranial Ultrasonography Guidelines for the Procedure and Atlas of Normal Ultrasound Anatomy
An overview of cerebral pathology as can be visualised by CUS is provided in the Atlas on Cranial Ultrasonography by Govaert and De Vries (1997). 1 A Systematic Approach to Detect Cerebral Pathology While looking for signs of pathology, a systematic approach is recommended. The following can be used as a guideline: • Are the anatomical structures distinguishable, and do they appear normal? 1) • Does the maturation of the brain (cortical folding) appear appropriate for GA? 2) • Is there a normal distinction between the cortex and the white matter?
If timing is not optimally chosen, if time intervals between CUS examinations are too long, or if CUS examinations are discontinued too early, important information and/or injury may be overlooked. Adequate outcome prediction will then be unreliable, and an unfavourable outcome may not be predicted. On the other hand, if the quality of CUS is good, timing is carefully chosen, proper transducers are used, and, in the case of preterm birth, serial examinations are continued until term age, most diagnoses will not remain undetected, and the reliability and prognostic value of CUS can be high.
2. 3. 4. 5. 6. 7. 8. Anderson N et al. (1994) Diagnosis of intraventricular hemorrhage in the newborn: value of sonography via the posterior fontanelle. AJR Am J Roentgenol 163:893–896 Anderson NG et al. (1995) Posterior fontanelle cranial ultrasound: anatomic and sonographic correlation. Early Hum Dev 42:141–152 Buckley KM et al. (1997) Use of the mastoid fontanelle for improved sonographic visualization of the neonatal midbrain and posterior fossa. AJR Am J Roentgenol 168:1021–1025 Correa F et al.