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State of the Art Cranial Ultrasound Imaging in Neonates
10:02

State of the Art Cranial Ultrasound Imaging in Neonates

Published on: February 2, 2015

Are routine cranial ultrasounds necessary in premature infants greater than 30 weeks gestation?

N Ja'Neice Harris1, Diana Palacio, Andrew Ginzel

  • 1Division of Neonatology, University of Texas Medical Branch, Galveston, Texas, USA.

American Journal of Perinatology
|November 10, 2006
PubMed

Insights

This study suggests limiting routine cranial ultrasounds (US) for premature infants. Screening may be appropriate for infants born at 30 weeks gestation or less, not all preterm infants.

Area of Science:

  • Neonatal neurology
  • Pediatric neuroimaging

Background:

  • Current guidelines recommend routine cranial ultrasonography for preterm infants.
  • The American Academy of Neurology and Child Neurology Society suggest screening at 7-14 days and 36-40 weeks postmenstrual age for infants <30 weeks gestation.
  • This study evaluates the efficacy of these guidelines in infants born between 30-33 weeks gestation.

Purpose of the Study:

  • To validate the existing practice parameter for screening cranial ultrasonography in preterm infants.
  • To determine the number of clinically significant abnormal screening ultrasounds that might be missed with current guidelines.
  • To assess the optimal gestational age cutoff for routine cranial ultrasound screening.

Main Methods:

  • Retrospective study of 486 infants born between 30 to 33 weeks gestation.
  • Analysis of screening cranial ultrasounds performed on these infants.
  • Evaluation of rates of Grade III/IV intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL).

Main Results:

  • Grade III/IV intraventricular hemorrhage (IVH) occurred in 0.8% of infants (30-31 weeks gestation).
  • Periventricular leukomalacia (PVL) was diagnosed in 1.4% of infants.
  • A significant trend toward fewer abnormal cranial ultrasounds was observed in infants from 30 to 33 weeks gestation (p=0.04).
  • Infants with significant findings had identifiable risk factors or symptoms.

Conclusions:

  • The study supports limiting routine screening cranial ultrasounds.
  • The findings suggest that the gestational age cutoff for screening should be 30 weeks or less.
  • Current screening protocols may be adjusted based on gestational age to optimize resource utilization and detection rates.

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