The Grand Unifying Theory of Bright Echoes in the Fetal and Neonatal Brain
Department of Radiology, University of California, 505 Parnassus Ave, San Francisco, CA 94143-0628 USA. .Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine (Impact Factor: 1.54). 10/2012; 31(10):1665-73.
The purpose of this presentation is to illustrate that the high-amplitude reflecting structures in the fetal and neonatal brain can be explained by the echogenicity of their leptomeningeal coverings or leptomeningeal origins. The leptomeninges, especially the pia mater, constitute the "grand unifying theory of bright reflectors" in the fetal and neonatal brain. Images from fetal and neonatal sonograms were selected to illustrate the objectives above.
- [Show abstract] [Hide abstract]
ABSTRACT: Findings of neonatal encephalopathy (NE) and specifically the findings of hypoxic-ischemic injury (HII) are frequently evident on MRI. Although MRI has become more widely used and has gained widespread acceptance as the study of choice for the evaluation of NE in recent years, MRI costs are high, and access to MRI is sometimes limited for extremely sick neonates. Therefore, head sonography (US) continues to be the first-line imaging modality for the evaluation of the brain in neonates with NE, furthermore, in many of these infants, the diagnosis of NE may have first been made or suggested using head US. US is non-invasive, inexpensive, and portable, allowing examinations to be performed without moving the infant. However, many of the telltale signs of NE on US are subtle and may be easily overlooked contributing to diagnostic delay or misdiagnosis. Herein, we aimed to illustrate the spectrum of US findings in NE, with emphasis on those findings that may be easily overlooked on US. Recognition of these findings could potentially improve detection rates, reduce errors, and improve patient management.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.