Elka Miller MD, Presenter: Nothing to Disclose

Alan Daneman MD, Abstract Co-Author: Nothing to Disclose

Jeffrey Traubici MD, Abstract Co-Author: Nothing to Disclose

Susan I. Blaser MD, Abstract Co-Author: Nothing to Disclose

Andrea Schwarz Doria MD, Abstract Co-Author: Nothing to Disclose

Manohar Meghraj Shroff MD, Abstract Co-Author: Nothing to Disclose

 To prospectively compare Doppler-Ultrasound of the cerebral venous sinuses in neonates with MRI and MR venography.

This prospective study was approved by the institutional research ethics board. Newborns undergoing clinically indicated MR venography of the brain from May 2007 to February 2008 underwent a dedicated Doppler ultrasound examination of the cerebral venous sinuses within 10 hours of the MR study, after appropriate written informed parental consent. Ultrasound was performed using a standard protocol, which included visualization of the venous system using all available acoustic windows (fontanels and sutures). The superior sagittal sinus (anterior, mid and posterior segments), sigmoid sinuses, transverse sinuses, deep cerebral venous system (inferior sagittal sinus, straight sinus and cerebral veins) and the upper cervical jugular veins were evaluated for patency of flow, size and Doppler velocity, and confidence of visualization. Ultrasound images were reviewed by two pediatric radiologists and MR venographies were reviewed by two pediatric neuro-radiologists independently. Disagreements were resolved by consensus.

Fifty consecutive neonates (30 boys; gestational age range between 25 to 41 weeks) underwent Doppler Ultrasound of the cerebral venous sinuses. Mean time interval between the date of birth and study was 19.1 days (SD of 30.6 days). None of the cases showed evidence of thrombosis. Agreement for US and MRI findings for the superior sagital sinus and the vein of Galen was excellent (100%). The cerebral veins, straight sinus, torcula, sigmoid sinus and superior jugular veins demonstrated a substantial agreement between the two studies (94-98%). Agreement for the left transverse sinus was 86% and for the right transverse sinus was 82% (technical sonographic difficulties in 6/40). Overall agreement of both studies was 90%.  In 6/50 cases, MRV showed flow disturbances that ultrasound was able to visualize as normal flow. Ultrasound showed the inferior sagital sinus in 35/50, whereas MRV only 15/50 cases.

Doppler ultrasound is a reliable technique for evaluation of normality of the cerebral venous sinuses in neonates  

Doppler ultrasound can be used to determine normality of cerebral venous sinuses in neonates, and when necessary as a complementary technique to MRV to evaluate flow disturbances.

Miller, E, Daneman, A, Traubici, J, Blaser, S, Doria, A, Shroff, M, Comparison of Doppler Ultrasound with MR Venography in the Evaluation of Cerebral Venous Sinuses in Neonates.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012320.html