Cranial ultrasonography in neonates: role and limitations

In experienced hands, cranial ultrasonography (cUS) is an excellent tool to detect the most frequently occurring brain abnormalities in preterm and full-term neonates, to study the evolution of lesions, and to follow brain maturation. It enables screening of the brain and serial imaging in high-risk neonates. However, cUS also has limitations and magnetic resonance imaging is needed in most neonates with (suspected) parenchymal brain injury and/or neurological symptoms and in very preterm infants. In this review, we discuss the applications, possibilities, indications, predictive value, and limitations of neonatal cUS. We will pay attention to the standard cUS procedure and expand on optimizing the possibilities of cUS by using supplemental acoustic windows and changing transducers and focus points. For illustration numerous cUS images are provided.