Neurosonography: in pursuit of an optimized examination

This article emphasizes technical factors that are helpful for optimizing sonographic examinations of the brain in preterm and term neonates. It also reviews existing data regarding the accuracy of neurosonographic examinations relative to MR. Many neurosonographic signs are subtle and can be easily overlooked, which could lead to delayed diagnosis or misdiagnosis. Therefore meticulous attention to sonographic technique is required to maximize the diagnostic utility of this modality. Although MR images of the brain often depict abnormalities more clearly than sonography, neurosonography continues to be an exceptionally valuable tool for evaluation of the neonatal brain, even in full-term neonates. Furthermore, its accuracy is greater, even in the latter age group, than many older publications suggest. Prospective studies using state-of-the-art equipment comparing findings on sonography and MR are needed to better understand how the accuracy of these modalities changes with refinements in equipment and to help us better understand the role of neurosonography relative to MR.