ADVANCES IN PEDIATRIC CNS ULTRASOUND

Advanced paediatric ultrasound of the central nervous system (CNS) req uires 7 MHz sector and linear transducers, equipment which is highly s ensitive to flow velocity (Power Doppler) and additional transcranial axial, coronal and sagittal imaging. New diagnostic possibilities incl ude recognition of subarachnoid hemorrhage (imaging of cisterns and/or CSF-flow); differentiation between subarachnoid and subdural fluid co llections (colour flow imaging of traversing veins); additional criter ia suggestive of spinal cord tethering (spinal cord pulsations); and g rey-white matter differentiation in newborn infants. A meticulous exam ination technique is mandatory when investigating suspected brain deat h, sinus venous thrombosis, diffuse early ischemia or viral (herpes) e ncephalitis. Anatomical areas such as the cerebral aqueduct, tentorium , Foramina of Luschka or circle of Willis which are not usually regard ed as accessible to cerebral echography can be visualized by advanced transcranial imaging technique. Indications for transcranial scanning; shortcomings of cerebral ultrasound; measures to overcome limitations ; and requirements for present and future ultrasound equipment are giv en and discussed in tables. (C) 1998 Elsevier Science Ireland Ltd.