Evaluation of congenital extracranial masses by waterpath sonography

Congenital scalp masses pose a diagnostic and management challenge. In the past the relationship of the lesion to the skull and intracranial contents have been assessed by skull x-rays and computed cranial tomography. Waterpath sonography is a non-invasive technique that utilizes no ionizing radiation for evaluating and monitoring congenital scalp masses. In two illustrative cases this method of imaging assisted in assessing the size, contents, and relationship of the congenital scalp masses to the intracranial contents. It enabled the surgeon to anticipate the avascular cystic nature of the congenital scalp masses, the intact underlying calvarium, and non-violation of the CSF pathways prior to surgery. The technique was also useful for monitoring progress after surgery.