Original Research Article
Year: 2020 | Month: January-March | Volume: 5 | Issue: 1 | Pages: 86-90
Role of Sonography of Brain through Anterior Fontanelle in Neonate
Shilpa Chudasama1, Bhargav Ravat2, Niraj Darji2
1Associate Professor, 2Resident
Department of Radiodiagnosis, Shri M.P. Shah Government Medical College and Shri GuruGovind Singh Government Hospital, Jamnagar.
Corresponding Author: Bhargav Ravat
ABSTRACT
Objectives:- The objective of this study was to evaluate the role of sonography in newborn and neonate brain through anterior fontanelle to identify brain pathology noninvasively and rapidly at bed side level.
Materials and methods: - Neonatal cranial ultrasonography (US) has traditionally relied on the anterior fontanelle as the primary acoustic window. We generally use phased-array, multiple-foci 5.0- or 7.0-MHz sector transducers (Esaote My Lab 40, My lab 60, Samsung AVXGE30). The proximity to the brainstem and posterior fossa afforded by the alternate windows (ie, the posterior and mastoid fontanelles) allows the use of higher-frequency probes in these areas, thereby increasing resolution. The anterior fontanelle, located at the junction of the coronal and sagittal sutures, is the largest fontanelle. Although anterior fontanelle imaging can be performed with the neonate in any position, imaging through the posterior and mastoid fontanelles is facilitated by placing the infant in the lateral decubitus position.
Results:- B-mode sonography had sensitivity of 82.5%, specificity of 63.6%, though MRI and CT imaging remains the investigation of choice but for early bedside evaluation for brain imaging in neonates, trans fontanelle ultrasonography is the choice to investigate.
Conclusions: - Neonatal intracranial sonography performed through the anterior fontanelle and with use of the posterior fontanelle and through the mastoid fontanelle—can significantly augment the diagnostic power of neurologic sonography in detecting brain abnormality findings like small intraventricular haemorrhages, subarachnoid haemorrhage, and hydrocephalus, choroidal cyst and in depicting structural abnormalities of the brainstem and cerebellum.
Keywords: Neonates, anterior fontanelle, Posterior and mastoid fontanelle, Sonography