Ultrasound of the Neonatal Head and Spine | GE Healthcare

Summary

This webinar, facilitated by Claire and presented by neonatologist Cheryl Rogerson, delves into neonatal head and spine ultrasound. Covering anatomy, scanning techniques, and pathology, it provides insights into optimal imaging, ventricular measurements, and conditions like interventricular hemorrhage and periventricular leukomalacia. The discussion also touches on the significance of the cerebellum, the importance of acoustic windows, and the implications of various findings for long-term outcomes in neonatal care.

Takeaways

• 🌟 The webinar, facilitated by Claire, focuses on neonatal head and spine ultrasound, featuring Cheryl Rogerson, a consultant neonatologist with extensive experience in the field.
• 🔍 Cheryl Rogerson has a passion for ultrasound and has contributed to its use and education globally, particularly in Malawi, and has published research on neonatal brain and spine conditions.
• 📚 The anatomy and windows for cranial ultrasound scanning are crucial for optimal imaging of the neonatal brain, including the anterior fontanelle and other sutures, as well as the foramen magnum for brainstem views.
• 👶 The routine scanning of neonates is recommended at specific time intervals post-birth, varying based on the infant's gestational age and clinical indications such as hemorrhage or leukomalacia.
• 📉 Ventricular measurements are vital for assessing the health of neonatal brains, with specific guidelines for measuring the anterior horn width, the third ventricle, and the fourth ventricle.
• 🩺 The presentation highlighted the importance of differentiating between various grades of interventricular hemorrhage and their implications for long-term outcomes in neonates.
• 🧊 The webinar discussed the significance of identifying and monitoring conditions like periventricular leukomalacia, which can be associated with cerebral palsy and developmental delays.
• 🌐 The use of pulse-doppler in ultrasound is instrumental in assessing blood flow, which can indicate conditions like raised intracranial pressure or intrauterine asphyxia.
• 🔊 The mastoid fontanel view is emphasized as essential for examining the posterior fossa and identifying cerebellar hemorrhages that may be missed with other views.
• 🤔 The script raises awareness about conditions that may not be pathological, such as lenticular straight artery echogenicity, which is commonly seen in preterm infants and not associated with adverse outcomes.
• 🔍 Spinal ultrasounds are a key aspect of neonatal care, particularly for infants with sacral dimples, and the webinar provides insights into when and how to perform these scans effectively.

Q & A

What is the main focus of the webinar presented by Cheryl Rogerson?

The webinar focuses on ultrasound scanning of the head and spine in neonates, covering topics such as anatomy, pathology, and the use of ultrasound in clinical settings.

How long is the webinar scheduled to run?

The webinar is scheduled to run for approximately 60 minutes.

What is Cheryl Rogerson's professional background in relation to the webinar topic?

Cheryl Rogerson is a consultant neonatologist with over 20 years of experience in ultrasound scanning of neonates, including work in Malawi and involvement with the neonatal SIPUC.

What are the standard scanning planes used in neonatal ultrasound?

The standard scanning planes include five coronal, five sagittal, a mastoid fontanel view, and additional optional images such as those of the cerebellum.

What is the significance of measuring the cerebellar diameter in relation to gestation?

The cerebellar diameter is measured to help determine the gestational age of an infant when it is uncertain, as there are published guidelines relating cerebellar diameter to gestation.

How is the long-term outcome for neonates being assessed using ultrasound?

Long-term outcomes are being assessed through serial ultrasounds that individualize a person's prognosis, moving away from percentages to more personalized predictions.

What is the importance of the mastoid fontanel view in neonatal ultrasound?

The mastoid fontanel view is crucial for examining the posterior fossa, as it is the only way to adequately visualize structures like the cerebellum and the fourth ventricle.

What is the role of pulse Doppler in neonatal ultrasound scans?

Pulse Doppler is used to assess blood flow in the cerebral arteries, which can indicate conditions such as raised intracranial pressure or intrauterine asphyxia.

How is the corpus callosum related to the agenesis of the corpus callosum condition?

In agenesis of the corpus callosum, the fibers that normally cross from left to right in the corpus callosum instead turn upward and form bundles of procce, leading to a high-riding third ventricle and a typical 'staghorn' appearance on imaging.

What are the implications of finding a sacral dimple in neonatal spinal ultrasound?

A sacral dimple may indicate an underlying spinal problem, but only if it is greater than 2.5 centimeters away from the anus, has associated hair or skin pigmentation, or is raised and cystic. Otherwise, it is considered a simple dimple and not associated with underlying spinal dysraphism.

How can the presence of a small anterior fontanelle in a neonate be assessed with ultrasound?

If a small anterior fontanelle is associated with concerns about suture fusion or overlapping, an ultrasound can be performed to examine the sutures and determine if they are open or closed, and to assess the head shape and size.