Ch 2 U/S of Neonatal Brain Flashcards
When does the anterior fontanelle window close?
Begins around 9 months + is completely closed by 15 months
What is the main imaging window used for imaging the neonatal brain?
Anterior fontanelle
(others include posterior + mastoid fontanelle)
Which probe should we use?
-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
What 3 structures are on our diagnostic checklist when scanning a neonatal brain?
-Ventricles (normal or dilated)
-Parenchyma (developing landmarks)
-Pulsation + extra axial spaces
When performing a neonatal brain exam, we want to know if the child is under/over ___ weeks?
32 weeks
How many images are there in the coronal protocol?
6-8
The right side of the brain is labelled on the ___ side of the image in the coronal protocol?
Left
Which fontanelle do we start imaging at with the coronal protocol?
Start at front of brain in anterior fontanelle, then slice through different locations moving more posterior
What coronal view is the most anterior image taken?
Coronal view 1
Which coronal view is taken through the frontal lobes at the level of the orbits + shows the interhemispheric fissure?
Coronal view 1
Which coronal view shows the frontal horns of the LVs + the CSP in between?
Coronal view 2
Which coronal view shows the frontal horns + is slightly more posterior?
Coronal view 3 (not always included in protocol)
Which coronal view is at the level of the foramen of monro, 3rd ventricle, CSP + sylvian fissures?
Coronal view 4
Which view do we measure the LVs?
Coronal view 4
Which coronal view shows the choroid plexus, sylvian fissures, tentorium, cerebellar hemispheres, cisterna magna + is posterior to 3rd ventricle?
Coronal view 5
Which coronal view shows the quadrigeminal cistern, thalami, cerebellum + choroid?
Coronal view 6
Which coronal view shows the trigones of the LVs + is the level where the glomi of the CP fills most of LVs?
Coronal view 7
Which coronal view should we compare the periventricular parenchyma to the CP?
Coronal view 7
(parenchyma should NOT be brighter than the CP)
What coronal view is the most posterior image taken?
Coronal view 8
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?
Coronal view 8
Which coronal view is not always included in the protocol?
Coronal view 3
How many coronal + SAG views are there?
COR: 8
SAG: 5
Where do we put our probe to image the brain in SAG?
Rotate 90 degrees from coronal in anterior fontanelle
The anterior/front of the brain is on the left side of the image in the SAG plane, how do we label this?
Label RT, LT or ML depending where we are angled
Which SAG view is directly midline?
SAG view 1
Which SAG view shows the hypoechoic CC above the CSP/vergae, 3rd + 4th ventricle, cerebellar vermis + CM?
SAG view 1
The CC is surrounded by the ___ artery?
Pericallosal
Is vergae seen in all neonatal brains?
No, only premies
Which SAG view shows the caudothalamic groove?
SAG view 2
The caudothalamic groove is formed by what 2 structures?
Head of caudate nucleus + thalamus
What is the m/c site for hemorrhage in premies?
Germinal matrix
(seen in SAG view 2)
Which SAG view shows the LV + the CP tapering to a point in the caudothalamic groove?
SAG view 3
(may need multiple images here with oblique angles to vis whole LV)
Is the frontal or occipital horn more medial?
Frontal
Which SAG view will show the glomus of the CP filling the trigone LV?
SAG view 4
Which SAG view shows the sylvian fissures, branches of the MCA + is lateral to the ventricles?
SAG view 5
List 3 additional imaging planes used?
-Posterior fontanelle
-Mastoid (posterolateral) fontanelle
-Superior SAG sinus
When would we image via the posterior fontanelle?
When assessing the occipital (posterior) horn of the LV
(place probe at mid/back of head)
When would we image via the mastoid fontanelle?
When assessing the posterior fossa/cerebellum
(place probe just behind ear)
When would we image via the superior SAG sinus?
When assessing the midline venous sinus + want to doppler for patency
(place probe in SAG at anterior fontanelle)
