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The intracranial venous system in infants: normal and abnormal findings on duplex and color Doppler sonography
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
Insights
This study highlights the clinical potential of Doppler ultrasound in evaluating the infantile cerebral venous system. It details normal venous appearance and abnormal hemodynamics, crucial for understanding neonatal brain injury.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Vascular imaging
Background:
- Venous hypertension is linked to neonatal brain injury, including periventricular hemorrhagic infarction and cerebrovascular injury post-extracorporeal membrane oxygenation (ECMO).
- Current Doppler ultrasound applications primarily focus on the intracranial arterial tree, with less emphasis on the cerebral venous system.
Purpose of the Study:
- To describe the sonographic appearance of the normal infantile cerebral venous system using color and duplex Doppler.
- To present a spectrum of venous hemodynamic abnormalities in critically ill infants.
- To familiarize clinicians with the diagnostic potential of Doppler techniques for the infantile cerebral venous system.
Main Methods:
- Utilized color and duplex Doppler sonography to image the cerebral venous system in infants.
- Described the characteristic sonographic findings of a normal infantile cerebral venous system.
- Documented and analyzed various abnormalities in venous hemodynamics.
Main Results:
- Established normative Doppler sonographic appearances for the infantile cerebral venous system.
- Identified and illustrated a range of abnormal venous hemodynamic patterns in critically ill neonates.
- Demonstrated the feasibility and clinical utility of Doppler sonography in assessing venous abnormalities.
Conclusions:
- Doppler sonography is a valuable tool for evaluating the infantile cerebral venous system.
- Understanding normal and abnormal venous hemodynamics is essential for diagnosing and managing neonatal brain injury.
- This technique offers significant clinical potential for critically ill infants with suspected venous compromise.
Abstract:
Venous hypertension has been implicated as an important factor in the pathogenesis of neonatal brain injury under a variety of circumstances, such as periventricular hemorrhagic infarction in the preterm infant [1], cerebrovascular injury after treatment with extracorporeal membrane oxygenation (ECMO) [2], and thrombosis of the superior sagittal sinus. Although duplex and color Doppler sonographic techniques have been used to evaluate the intracranial arterial tree for several years, little attention has been paid to the role of Doppler techniques in the evaluation of the cerebral venous system. We describe the appearance of the normal infantile cerebral venous system on color and duplex Doppler sonograms and present a spectrum of abnormalities in venous hemodynamics in critically ill infants with the goal of familiarizing readers with the clinical potential of this technique.