The Added Values Of Duplex Study And Cranial Ultrasonography In Clinically Suspected Preterm Brain Injury

Fathy, Khaled Ahmad; Osman, Nasr; Abdelmaboud, Mohamed; Abdel Samie, Mohamed Ahmed

doi:10.21608/mjmr.2023.192250.1341

The Added Values Of Duplex Study And Cranial Ultrasonography In Clinically Suspected Preterm Brain Injury

Document Type : Original Article

Authors

¹ Radiology, Medicine, El Minia university, El Minia, Egypt

² radiology department ,faculty of medicine ,minia university

³ Department of pediatrics, El-Minia faculty of medicine

⁴ Radiology, Faculty of Medicine, Minia university, egypt

10.21608/mjmr.2023.192250.1341

Abstract

Our study was conducted on 50 premature infants (than 32 weeks) with clinically suspected preterm brain injury. All patients underwent cranial ultrasonography using high-resolution sonography machines at NICU of Minia University Hospitals.

Radiological investigations were done for all cases and controls including transcranial sonar, and transcranial Doppler studies of ICA, MCA and ACA for mean velocity, PSV and resistive index.

Grading system for germinal matrix haemorrhage/ intra ventricular haemorrhage (GMH/IVH) by Volpe is based on cranial ultrasound scan (CUS). Grade I refers to haemorrhage confined to the subependymal GM, and grade II as haemorrhage within the lateral ventricle without ventricular dilation and/or haemorrhage occupying less than 50% of the ventricle. Grade III haemorrhage is defined by ventricular dilation and/or haemorrhage occupying more than 50% of the ventricle, while grade IV is ventricular haemorrhage with periventricular hemorrhagic infarction. 40 % had GMH/IVH in the US. Among those 35.3% were grade 1, 29.4% were grade 2, 23.5% were grade 3, while 11.8% were grade 4. Associated pathology found among these cases included: 10 % had cerebellar haemorrhage,. 15 % had signs of brain edema by Doppler (an early finding) among them 5 % had progressed to just periventricular echogenicity (PVL – grade I), whereas 10 % progressed to periventricular cystic leukomalacia at TEA (PVL – grade II – IV).

The positive cases had a significantly lower age and weight than the negative. Transcranial Doppler findings revealed higher mean velocity and lower PI & RI in preterms.

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