谷野 定之¹, 中島 裕司¹, 宮尾 益知¹, 柳沢 正義¹, 鴨下 重彦¹, 伊東 紘一²

Sadayuki YANO¹, Yuji NAKAJIMA¹, Masutomo MIYAO¹, Masayoshi YANAGISAWA¹, Shigehiko KAMOSHITA¹, Kouichi ITOH²

¹自治医科大学小児科, ²自治医科大学臨床病理

¹Department of Pediatrics, Jichi Medical School, ²Department of Clinical Pathology, Jichi Medical School

キーワード : ultrasonography, sector scanner, anterior fontanelle, intracranial, abnormalities, eight standard planes

Using two-dimensional ultrasonography, we were able to observe normal intracranial structures and various abnormalities in newborns and young infants. In this study, we used a 5-MHz mechanical sector scanner placing the transducer probe directly over the anterior fontanelle. The probe was aimed in both coronal and sagittal sections for three dimensional evaluation of the brain structures.
Normal brain structures such as the ventricles, choroid plexus, corpus callosum, thalamus, lenticular nucleus, cerebral gyri or cerebellum could be observed. Various abnormalities such as ventricular dilatation, intraventricular hematoma in hemophilia A, cerebellar tumor or destructive changes of the brain parenchyma in herpes simplex encephalitis, were detected.
This method had many advantages in comparison with CT in the following points. The scanner was less expensive than CT scanner was. Ultrasound was thought to be non-invasive for the neonatal brain. As the unit was portable and the procedure did not require sedation of the patient, we were able to examine premature infants in their incubators observing the recorded images simultaneously. On the recorded images of this method, the contrast of the ventricular system and the brain parenchyma was clear even in premature infants or patient with encephalitis. The basal ganglia and cerebral cortex showed different echogenicity, and the choroid plexus was highly echogenic without contrast enhancement on this method. In conclusion, we stress the usefulness of this method in observing various intracranial abnormalities in infancy. Some improvements on portability or resolution of the scanner will be expected.