新生儿颅脑超声影像.pptx

新生儿颅脑超声影像 Neurosonography 1Technique, Indication, AnatomyProtocolIVH PVLSpinal Sonography Technique and IndicationRoutinely for premature infants at 6 days and 4 weeks and as needed to rule out Intraventricular Hemorrhage and Periventricular Leukomalacia, as well as other abnormalitiesTypically up to 9 months or as long as fontanelle is openUse anterior fontanelle mostly, also transmastoid and posterior for better visualization of the posterior fossa and 4th ventricleHighest frequency transducer to allow sufficient penetration and resolution (curved or vector), linear images to define superficial structures AnatomyCorpus CollosumCSPCavum VergaeVelum InterpositumVentriclesChoroid PlexusCerebellumCaudate NucleusThalamusSylvian FissuresCircle of WillisCerebral HemispheresBrain CoveringLobes of Cerebrum Lobes of CerebrumTemporalParietalFrontalOcciptal VentriclesLateral Ventricle -Frontal Horn -Body -Occipital Horn -Temporal Horn AnatomyCSF Pathway-Choroid Plexus-Lateral Ventricles-Foramina of Monro -3rd Ventricle-Aqueduct of Sylvius-4th Ventricle-Foramina of Magendie and Luschka-Foramen Magnum AnatomyCovering of BrainSubdural VsSubarachnoidSubarachnoidSpaceSubduralSpace BESSI(Benign Enlargement of the Subarachnoid  Spaces of Infancy)Enlargement of frontal, temporal extracerebral CSF spaces, enlargement of the frontal horns, and macrocephalyWill show bridging cortical veins (to distinguish between subdural collections which are never benign) Subarachnoid VsSubdural Subarachnoid VsSubdural ProtocolCoronal Images (frontal ? occipital)Frontal at level of orbitsOrbital BonesFrontal horns Anterior to Foramen of MonroMCA Region (Measure Lat. Vents.)Foramen of MonroPosterior aspect of 3rd ventricle through thalamiCerebellum and Lateral Vents. BodiesTentoriumLaertal Vents. Including Choroid PlexusCortex of occipital lobes and posterior Interhemispheric Fissure (periventricular white matter) ProtocolCoronalMCARegion of Circle of WillisMCAMeasure Lat. Vents