Main Logo
Logo

Society for Pediatric Radiology – Poster Archive

  191
  0
  0
 
 


Final ID: Paper #: 123

Feasibility of Intracranial Contrast-Enhanced Ultrasound in Neonates: Comparison with MRI

Purpose or Case Report: Timely intracranial imaging enables diagnosis, directs treatment, and provides prognostic information of infant malformation or injury. MRI is the gold standard for neuroimaging, but can be inhibited by transportation risk and incompatible support devices. Ultrasound (US) is portable, rapid, and inexpensive, but limited by lower sensitivity and specificity. Contrast-enhanced ultrasound (CEUS) improves diagnostic accuracy of US in other clinical applications. Our aim was to prospectively compare CEUS of the neonatal brain to MRI.
Methods & Materials: Infants in our NICU with vascular access undergoing brain MRI were recruited. A GE Logiq E9 or E10 US system (GE Healthcare Milwaukee, WI) was used, performed by a radiologist blinded to MRI results. The contrast agent (Lumason, Bracco Diagnostics, Monroe Township, NJ) was used off-label, with dose of 0.03mL/kg IV, per departmental CEUS protocol. Infants were monitored for adverse events. CEUS followed routine US. Coronal plane cinematic clips were saved during wash-in of contrast, followed by coronal and sagittal sweeps of the entire brain parenchyma, with trans-mastoid sweeps last.
Results: Twenty-three neonates (mean age 17 days, mean gestational age 37+4 weeks) were imaged on average 17.5 hours following MRI. MRI indications included: 6 infection, 6 seizure, 4 suspected hypoxic ischemic injury, 4 follow-up malformations, 2 abnormal prior screening US, 1 prematurity. CEUS examinations were diagnostic quality and improved diagnosis compared to US. MRI and CEUS were concordant in 13 patients (57%) and discordant in 10 (43%). Discordances, with diagnoses seen only on MRI, included tiny acute infarct, small ischemic hemorrhagic transformation (ischemia was concordant), hemosiderin staining from old intraventricular hemorrhage, small posterior fossa subdural hemorrhages, and brainstem calcifications, several of which were clinically insignificant. Two MRI abnormalities not seen on CEUS had normal follow up MRI, including focal T2 signal hyperintensity and focal hyperperfusion on arterial spin labeling. One case of MCA infarct luxury reperfusion was seen at CEUS but not MRI. There were no false positive CEUS cases and no adverse events with CEUS were encountered.
Conclusions: Neonatal brain CEUS is feasible, safe, and increases diagnostic ability of US. Additionally, CEUS directly visualizes dynamic vascular perfusion that may prove to be an added benefit of CEUS over MRI. Although further study is needed, CEUS may be a valuable additional diagnostic tool.
  • Squires, Judy  ( UPMC Children's Hospital of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Beluk, Nancy  ( UPMC Children's Hospital of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Yanowitz, Toby  ( UPMC Children's Hospital of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Kephart, Morie  ( Aureus Medical , Omaha , Nebraska , United States )
  • Panigrahy, Ashok  ( UPMC Children's Hospital of Pittsburgh , Pittsburgh , Pennsylvania , United States )
Session Info:

Scientific Session V-A: Fetal/Neonatal

Fetal Imaging / Neonatal

SPR Scientific Papers

More abstracts on this topic:
Quantitative analysis detects abnormalities in MRI scans reported ‘Normal’ in neonates with hypoxic ischemic encephalopathy (HIE)

Vyas Rutvi, Morton Sarah, Nunes Deivid, Song Yanan, Grant Ellen, Ou Yangming

Peripherally inserted central catheters (PICCs) in Neonates: is there real thrombus?

Durand Rachelle, Acord Michael, Srinivasan Abhay, Krishnamurthy Ganesh, Saade-lemus Sandra, Cahill Anne Marie, Kaplan Summer

More abstracts from these authors:
Pediatric cervical spine trauma revisited.

Akbari Yasmin, Subramanian Subramanian, Furtado Andre, Panigrahy Ashok, Zuccoli Giulio

Ultrasound-MRI correlation of neonatal intracranial abnormalities: beyond germinal matrix hemorrhage

Squires Judy, Zuccoli Giulio, Lynda Flom, Subramanian Subramanian, Panigrahy Ashok

Preview
Paper____123.pdf
You have to be authorized to contact abstract author. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.

Not Available

Comments

We encourage you to join the discussion by posting your comments and questions below.

Presenters will be notified of your post so that they can respond as appropriate.

This discussion platform is provided to foster engagement, and stimulate conversation and knowledge sharing.

Please click here to review the full terms and conditions for engaging in the discussion, including refraining from product promotion and non-constructive feedback.

 

You have to be authorized to post a comment. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.


   Rate this abstract  (Maximum characters: 500)