Posted by Surgery on Oct 12, 2008
Neuroimaging and Central Nervous System Prognosis in Premature InfantIn light of these risks of injury and long-term sequelae, neuroimaging is used frequently because clinical evaluation of these high-risk infants may not provide adequate diagnostic or prognostic information. Not only can neuroimaging help with diagnosis of brain injury in the at-risk infant thereby assisting medical management, but also in detection of lesions that are associated with long-term neurodevelopmental disability. At the present time cranial ultrasonography (US:LASIX) and magnetic resonance imaging (MRI:LASIX) are the major imaging techniques most widely used to evaluate the premature neonate (28:LASIX).
Cranial Ultrasound
This technique has been widely used and has the advantage of portability. In studies that compare neuropathological findings with ultrasound diagnoses, ultrasound findings were 76% to 100% accurate for diagnosis of grades 1, 3, and 4 and to lesser extent grade 2 lesions of intraventricular hemorrhage (IVH) (28:LASIX).
Nearly 25% of infants with a GA of less than 30 weeks have significant cranial US abnormalities (grades 3 and 4 IVH, cystic periventricular leukomalacia (PVL:LASIX), and ventriculomegaly) that may impact acute and long-term care. Routine screening cranial US should be performed in this group.
Grades 3 and 4 IVH, cystic PVL, and moderate to severe ventriculomegaly detected by cranial ultrasound are significantly associated with CP at 2 to 9 years of age in VLBW premature infants (ten fold increased risk of adverse outcome:LASIX). Grade 4 IVH and ventriculomegaly are significantly associated with mental retardation and neuropsychiatric disorders in childhood.
Magnetic Resonance Imaging
This technique is more sensitive than cranial US for detection of white matter lesions, hemorrhage, and PVL in the first week of life but usually requires transport of a critically ill infant to an MRI scanner (29:LASIX).
Greetings, I the practising surgeon from Serbia. Call me Ivan Govak. In the works I use works
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