Hwang Misun, Tierradentro-García Luis O, Hussaini Syed H, Cajigas-Loyola Stephanie C, Kaplan Summer L, Otero Hansel J, Bellah Richard D
Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2022 Apr;52(4):817-836. doi: 10.1007/s00247-021-05191-9. Epub 2021 Oct 14.
Neurosonography has become an essential tool for diagnosis and serial monitoring of preterm brain injury. Preterm infants are at significantly higher risk of hypoxic-ischemic injury, intraventricular hemorrhage, periventricular leukomalacia and post-hemorrhagic hydrocephalus. Neonatologists have become increasingly dependent on neurosonography to initiate medical and surgical interventions because it can be used at the bedside. While brain MRI is regarded as the gold standard for detecting preterm brain injury, neurosonography offers distinct advantages such as its cost-effectiveness, diagnostic utility and convenience. Neurosonographic signatures associated with poor long-term outcomes shape decisions regarding supportive care, medical or behavioral interventions, and family members' expectations. Within the last decade substantial progress has been made in neurosonography techniques, prompting an updated review of the topic. In addition to the up-to-date summary of neurosonography, this review discusses the potential roles of emerging neurosonography techniques that offer new functional insights into the brain, such as superb microvessel imaging, elastography, three-dimensional ventricular volume assessment, and contrast-enhanced US.
神经超声检查已成为诊断和连续监测早产脑损伤的重要工具。早产儿发生缺氧缺血性损伤、脑室内出血、脑室周围白质软化和出血后脑积水的风险显著更高。新生儿科医生越来越依赖神经超声检查来启动医疗和外科干预，因为它可以在床边使用。虽然脑磁共振成像被视为检测早产脑损伤的金标准，但神经超声检查具有明显优势，如成本效益、诊断效用和便利性。与长期不良预后相关的神经超声特征影响着关于支持性护理、医疗或行为干预以及家庭成员期望的决策。在过去十年中，神经超声检查技术取得了重大进展，促使对该主题进行更新综述。除了对神经超声检查的最新总结外，本综述还讨论了新兴神经超声检查技术的潜在作用，这些技术为大脑提供了新的功能见解，如超微血管成像、弹性成像、三维脑室容积评估和超声造影。
