Purpose or Case Report: To survey active members of the Society for Pediatric Radiology regarding their utilization of various cranial ultrasound techniques and reporting practices in neonates.
Methods & Materials: An online 10-question survey was distributed to SPR members to assess pediatric radiologist’s practice patterns of neonatal cranial ultrasound including protocol details, perceived utility, and reporting preferences.
Results: Of the 151 respondents, there was representation from academic, community, private practice and teleradiology pediatric radiologists. Not all respondents answered every question. The majority reported working in a free-standing children’s hospital as their primary practice site (87/151, 57.62%). All responding members reported that the anterior fontanelle approach was standard practice (150/150, 100%). Other views or techniques that were more commonly employed were high-resolution probe in the near field (86/150, 57.72%), mastoid view (80/150, 53.33%), and color Doppler for vessel patency (74/150, 49.33%). A majority reported use of template reporting (108/150, 72%). Spectral Doppler is variably used across clinical practices, with its most frequent use in detecting venous sinus thrombosis (59/111, 53.15%) and hypoxic ischemic injury (47/111, 42.34%). Of those who utilize spectral Doppler, resistive indices and/or pulsatility indices were reported with trends. Over half of respondents were “not sure” how Doppler assessment assists in patient management (78/121, 64.46%). Over half of respondents reported using sonographic indices for changes in ventricular size (84/141, 56.38%). In reporting germinal matrix hemorrhage, over half of those surveyed grade on the first ultrasound only and report descriptive changes on follow-up (84/150, 56.00%). Nearly one-third re-grade germinal matrix hemorrhages on follow-up ultrasound (45/150, 30.00%).
Conclusions: Our results demonstrate that there are some consistent uses of cranial ultrasound techniques, such as relying on anterior fontanelle views, preference for template reporting, and usefulness of linear high resolution near-field evaluation across SPR active members, while there exists fairly dramatic variability or uncertainty when it comes to interpreting or utilizing spectral Doppler for arterial evaluation and reporting practices in grading germinal matrix hemorrhage. These results may be useful in guiding future education and research efforts by the society.