Ch 2 U/S of Neonatal Brain Flashcards

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1
Q

When does the anterior fontanelle window close?

A

Begins around 9 months + is completely closed by 15 months

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2
Q

What is the main imaging window used for imaging the neonatal brain?

A

Anterior fontanelle

(others include posterior + mastoid fontanelle)

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3
Q

Which probe should we use?

A

-High frequency 7-10 MHz curved or sector probe m/c used

-High frequency 10-15 MHz linear probe for superficial structures can be used

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4
Q

What 3 structures are on our diagnostic checklist when scanning a neonatal brain?

A

-Ventricles (normal or dilated)
-Parenchyma (developing landmarks)
-Pulsation + extra axial spaces

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5
Q

When performing a neonatal brain exam, we want to know if the child is under/over ___ weeks?

A

32 weeks

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6
Q

How many images are there in the coronal protocol?

A

6-8

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7
Q

The right side of the brain is labelled on the ___ side of the image in the coronal protocol?

A

Left

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8
Q

Which fontanelle do we start imaging at with the coronal protocol?

A

Start at front of brain in anterior fontanelle, then slice through different locations moving more posterior

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9
Q

What coronal view is the most anterior image taken?

A

Coronal view 1

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10
Q

Which coronal view is taken through the frontal lobes at the level of the orbits + shows the interhemispheric fissure?

A

Coronal view 1

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11
Q

Which coronal view shows the frontal horns of the LVs + the CSP in between?

A

Coronal view 2

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12
Q

Which coronal view shows the frontal horns + is slightly more posterior?

A

Coronal view 3 (not always included in protocol)

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13
Q

Which coronal view is at the level of the foramen of monro, 3rd ventricle, CSP + sylvian fissures?

A

Coronal view 4

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14
Q

Which view do we measure the LVs?

A

Coronal view 4

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15
Q

Which coronal view shows the choroid plexus, sylvian fissures, tentorium, cerebellar hemispheres, cisterna magna + is posterior to 3rd ventricle?

A

Coronal view 5

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16
Q

Which coronal view shows the quadrigeminal cistern, thalami, cerebellum + choroid?

A

Coronal view 6

17
Q

Which coronal view shows the trigones of the LVs + is the level where the glomi of the CP fills most of LVs?

A

Coronal view 7

18
Q

Which coronal view should we compare the periventricular parenchyma to the CP?

A

Coronal view 7

(parenchyma should NOT be brighter than the CP)

19
Q

What coronal view is the most posterior image taken?

A

Coronal view 8

20
Q

Which coronal view is at the level of the occipital lobe, shows the posterior aspect of the interhemispheric fissure + shows normal echogenic periventricular white matter?

A

Coronal view 8

21
Q

Which coronal view is not always included in the protocol?

A

Coronal view 3

22
Q

How many coronal + SAG views are there?

A

COR: 8
SAG: 5

23
Q

Where do we put our probe to image the brain in SAG?

A

Rotate 90 degrees from coronal in anterior fontanelle

24
Q

The anterior/front of the brain is on the left side of the image in the SAG plane, how do we label this?

A

Label RT, LT or ML depending where we are angled

25
Q

Which SAG view is directly midline?

A

SAG view 1

26
Q

Which SAG view shows the hypoechoic CC above the CSP/vergae, 3rd + 4th ventricle, cerebellar vermis + CM?

A

SAG view 1

27
Q

The CC is surrounded by the ___ artery?

A

Pericallosal

28
Q

Is vergae seen in all neonatal brains?

A

No, only premies

29
Q

Which SAG view shows the caudothalamic groove?

A

SAG view 2

30
Q

The caudothalamic groove is formed by what 2 structures?

A

Head of caudate nucleus + thalamus

31
Q

What is the m/c site for hemorrhage in premies?

A

Germinal matrix

(seen in SAG view 2)

32
Q

Which SAG view shows the LV + the CP tapering to a point in the caudothalamic groove?

A

SAG view 3

(may need multiple images here with oblique angles to vis whole LV)

33
Q

Is the frontal or occipital horn more medial?

A

Frontal

34
Q

Which SAG view will show the glomus of the CP filling the trigone LV?

A

SAG view 4

35
Q

Which SAG view shows the sylvian fissures, branches of the MCA + is lateral to the ventricles?

A

SAG view 5

36
Q

List 3 additional imaging planes used?

A

-Posterior fontanelle
-Mastoid (posterolateral) fontanelle
-Superior SAG sinus

37
Q

When would we image via the posterior fontanelle?

A

When assessing the occipital (posterior) horn of the LV

(place probe at mid/back of head)

38
Q

When would we image via the mastoid fontanelle?

A

When assessing the posterior fossa/cerebellum

(place probe just behind ear)

39
Q

When would we image via the superior SAG sinus?

A

When assessing the midline venous sinus + want to doppler for patency

(place probe in SAG at anterior fontanelle)