Neonatal Cranial Ultrasonography: Guidelines for the Procedure and Atlas of Normal Ultrasound Anatomy

Cranial Suture Measurement by 2-point Method in Ultrasound Screening of Craniosynostosis
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I anticipate that this compact, easy-to-read, well-illustrated book will become popular with radiology, neonatology and sonography trainees alike. I would recommend it to anyone who is learning the technique of neonatal cranial ultrasonography. Students should find the anatomy and illustrations very helpful as orientation to this technique. I would recommend this book to every department that provides neonatal cranial sonography Convert currency.

Add to Basket. Soft cover. Condition: New. Seller Inventory More information about this seller Contact this seller. Book Description Springer, Never used!. Seller Inventory P Book Description Springer. Condition: new. Two infants were excluded from the study because they stopped outpatient visits early. The mean patient age was 6.

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Download Citation on ResearchGate | Neonatal cranial ultrasonography: Guidelines for the procedure and atlas of normal ultrasound anatomy | Despite. Editorial Reviews. Review. From the reviews: "This is a practical guide to neonatal cranial Buy Neonatal Cranial Ultrasonography: Guidelines for the Procedure and Atlas of Normal Ultrasound Anatomy: Read 4 Kindle Store Reviews.

Children with normal skulls routinely visited Osaka Medical College Hospital for the treatment of cleft lip and polysyndactyly. We chose 20 infants of them randomly.

Peri Ventricular Leukomalacia (PVL)

Access in-depth guidance on the must-know elements of each pharmacologic principle with clear, concise notes located beneath the corresponding image. Seller Inventory P Provides critical assessments of systematic reviews compiled from a variety of medical journals. Screening by ultrasonography can reduce the number of x-rays and CT scans. Provides fulltext access to Lane's resources. This work deals with the basics of neonatal cranial ultrasonography and can be used as a reference text by practitioners.

Two infants were excluded from the study because they were suspected of having the syndrome. The mean patient age was 7. Children with deformational plagiocephaly and normal skulls underwent echocardiographic examinations at regular intervals. The 8 patients consisted of 2 coronal, 2 lambdoid, 2 metopic, and 2 complex craniosynostoses. Bone fusion was also confirmed in intraoperative findings, and ultrasound was also performed directly on the periosteum after elevating the scalp flap. The mean age of patients undergoing the operation was 6.

All infants were assessed with cranial ultrasound of the sutures. The procedure was well-tolerated by all the infants, without any sedation. The bilateral coronal, metopic, sagittal, and bilateral lambdoid sutures were searched. Children with deformational plagiocephaly and normal skulls underwent ultrasound examinations at regular intervals after outpatient clinic.

Children with craniosynostosis underwent ultrasound examination after preoperative CT diagnosis. Since the examinations took place in 2 hospitals, 2 echocardiographic instruments were used, and linear probes for observing the surface layer were used. Linear transducers of 16 and 10 MHz were used with the following parameters: field of view, 1. Gel was used as contact medium. All children were examined by the author to avoid interobserver variability. While observing with echocardiographic ultrasound, we focused on the following measurement indices and decided the observation order so that evaluation could be made more easily in a short time Fig.

The ultrasound probe is vertically placed on 2 trisected points of the suture line between the 2 fontanels red lines.

First, the examiner confirmed the position of 6 cranial fontanels anterior fontanel, posterior fontanel, sphenoid fontanels, and mastoid fontanels , and these fontanels were used as measurement indicators. Therefore, the examination was begun in the order of the right coronal, left coronal, metopic, and sagittal suture. Furthermore, we have developed an evaluation method, which is easy to visualize Fig. Whether the suture was normal or fused was judged by using 2 observation points for each suture and was recorded in the table. If the suture was closed at 1 of the 2 points, a judgment was made that the suture was fused.

If only 1 of the 2 points is marked as closed, it is judged that the suture is fused. From this table, it can be immediately recognized whether the suture is normal or fused. The distance of the normal suture was measured for evaluation Fig. The line connecting the cortical epiphysis with a straight line was taken as the horizontal direction of the upper end.

The straight line connecting the boundary between the cortex and medulla was taken as the horizontal direction of the lower end. The average value of the 2 widths upper end and lower end was taken as the horizontal width of the suture. The line connecting the vertical distance between the epiphyseal leanings was taken as the vertical direction of the upper end. The line connecting the cortex and medulla border in the vertical direction at the same leanings was taken as the vertical direction of the lower end.

The average value of the 2 widths of the upper and lower ends was taken as the vertical width of the suture. The average of the upper end and the lower end was taken as the horizontal and vertical width of the suture, respectively. Similarly, we investigated patency or closure of all sutures by echocardiographic examination. Sutures were also observed with echocardiography when the bones were exposed during surgery and were directly visible. Four patients underwent endoscopic resection without ultrasound assessment on the periosteum, and closure of the suture was confirmed only by direct observation.

In all the normal and deformational plagiocephaly cases, the patency of the sutures was clearly confirmed by echocardiographic ultrasound Fig. When each fontanel, especially the anterior fontanel, was widely patent, the entire suture lines could be identified from the fontanels at both ends of the suture. Normal cranial sutures were patent if no bridging was found and an anechoic gap was present throughout their entire length. The periosteum, cortical bone, medulla bone, and dural layer could also be identified. In the coronal sutures and lambdoid sutures, bone overlap phenomenon was not particularly regular.

Sedation was unnecessary for the patients. A 2-month-old girl with a normal cranium. All the sutures are clearly open. The sutures have no bridging image and an anechoic gap is present throughout the entire bone. The periosteum, cortical bone, medulla bone, and dura mater could also be identified. Furthermore, it was possible to observe suture width over time in normal and deformational plagiocephaly. The value of the normal suture was larger in the horizontal direction than in the vertical direction, and the distance in the horizontal direction could be measured easily Fig.

Therefore, the width of the suture was defined as the horizontal direction with the greatest change depending on age. The average widths of the coronal sutures of the normal infants are shown.

Neonatal Spine Imaging

The values were larger in the horizontal direction than in the vertical direction at both the proximal and distal sites. In normal and deformational plagiocephaly, the suture width was narrowing with age Fig. Among all the sutures, the coronal sutures tended to be narrow. The width of the suture exceeded the echocardiographic resolution even at 2 years of age at the cortical suture measurement point.

Suture widths of infants with normal skulls and deformational plagiocephaly are gradually narrowing with increasing age. The coronal sutures were the narrowest of all sutures. The widths of the sutures exceeded the echocardiographic resolution dotted line even at 2 years of age. On the other hand, there was no anechoic gap in craniosynostosis and the bone was fused continuously Fig. The echocardiographic results of craniosynostosis were consistent with all the CT examinations. Results of CT findings, preoperative echogenic findings, intraoperative findings, and echogenic findings on periosteum did not differ.

Furthermore, in 4 of 8 cases it was consistent with intraoperative findings and the results when performed directly on the periosteum. The table can be entered quickly in order of measurement and is easy to visualize later. A 5-month-old girl with metopic craniosynostosis.

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A, Three-dimensional CT confirmed abnormal closure of the metopic suture. B, Ultrasound image showed disappearance of the hypoechogenic gap between the metopic bones. C, Ultrasound results are easy to visualize by filling out the table. According to the evaluation method for the 2-point method that we devised, all the sutures could be inspected in about 2 minutes.

Two cases of deformational plagiocephaly seemed to have cross-links in the coronal suture at 11 months. However, when observations were made at 12 months, it was confirmed that both cases were clearly patent. One case of deformational plagiocephaly seemed to have cross-links in the coronal suture at 18 months. Because we could not follow the patient, we could not confirm the patency of the suture.

It is rare for a patient to receive a first-time diagnosis for craniosynostosis as an outpatient.

Neonatal Brain US

Even when clinical findings do not lead to diagnosis, follow-up observations are necessary. Although x-ray examination is used as the first choice, it cannot be performed frequently due to the risk of irradiation. Although the guideline for craniosynostosis recommends repeating x-rays after 1 or 2 months, it says x-rays are not always reliable because of the very young age of the patient.

This leads to the temptation to use it for screening. Amoxicillin works by shielding minor life outlines from making, and executing th.. Read More. RM Add to My List. Added to Cart. Pediatric Emergency Critical Care and Ultrasound. Emergency bedside ultrasound assessment is well established for adult patients, but has only recently been introduced into everyday clinical practice for the care of pediatric patients.

Pediatric Emergency and Critical Care Ultrasound is a concise, practical text which explains the principles of ultrasound, its diagnostic application in all organ systems and its use as a procedural adjunct. Both well-established and innovative applications are described, assisting the practitioner in incorporating ultrasound into daily practice, facilitating patient care and decreasing radiation exposure.

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The aim is to enable the reader consistently to obtain images of the highest quality and to interpret them correctly. Essential information is provided both on the procedure itself and on the normal ultrasound anatomy.

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The standard technique is described and illustrated, and emphasis is placed on the value of supplementary acoustic windows. Attention is also drawn to maturational changes in the neonatal brain and to the limitations of cranial ultrasonography. Frequently occurring abnorm.. Introduction to Musculoskeletal Ultrasound: Getting Started. This is the first truly foundational, introductory text designed to help novice practitioners master the fundamentals of musculoskeletal ultrasound. For the new practitioner who has yet to hold a transducer, Dr. Strakowski makes beginning easy and presents detailed step-by-step instructions for operating the equipment, obtaining good images, and successfully interpreting sonograms.

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