Öz
Aim: In this study, it was aimed to reveal the diagnostic profile of the patients who underwent
transfontanelle ultrasonography (TFUSG) for various indications in pediatric practice.
Material and Methods: In this study, the records of 0 to 2 years aged patients, who underwent
transfontanelle ultrasonography for various indications at general pediatrics or pediatric neurology
outpatient clinics of Balikesir University, Faculty of Medicine between 01.08.2019-18.10.2021, were
retrospectively analyzed. TFUSG findings were divided into two subgroups as normal/variations of
normal and abnormal.
Results: A total of 183 cases, 77 (42.1%) female and 106 (57.9%) male, were included in the study.
The mean age of the cases was 119.55±134.52 days (1-700 days). The most common reasons for
requesting TFUSG were; various etiologies (n=79, 43.2%), seizures (n=37, 20.2%), and a history of
hospitalization in the neonatal intensive care unit (n=23, 12.6%). TFUSG was abnormal in 30 (16.4%)
cases. The most common abnormal TFUSG findings were; enlarged cerebrospinal fluid (CSF)
distances (n=8, 4.4%), hydrocephalus (n=7, 3.8%), and enlarged subarachnoid space (n=5, 2.7%).
Among groups with normal or abnormal TFUSG results, statistically significant differences were found
in terms of gender, birth weight according to gestational age and head circumference (p=0.007,
p=0.048, p=0.00, respectively).
Conclusion: The significant difference in TFUSG findings of patients aged 0 to 2 years, in terms of
gender, birth weight and head circumference according to gestational age is the feature that makes
our study stand out and this finding that needs to be studied more comprehensively.
Anahtar Kelimeler
Child ultrasonography clinic diagnosis Child, ultrasonography, clinic, diagnosis
Kaynakça
- Nzeh DA, Erinle SA, Saidu SA, Pam SD. Transfontanelle ultrasonography: an invaluable tool in the assessment of the infant brain. Trop Doct. 2004 Oct; 34(4): 226-7. doi: 10.1177/004947550403400413. PMID: 15510949.
- Harmat G. Intracranial sonography in infancy. Acta Paediatr Hung. 1985; 26(1): 15-29. PMID: 3885973.
- Dawbury K. Ultrasound of the infant brain. In: Sutton D (ed). Textbook of radiology and imaging 6 th edition. Churchill Livingstone,London; 1998:1651-56.
- Estan J, Hope P. Unilateral neonatal cerebral infarction in full term infants. Arch Dis Child Fetal Neonatal Ed. 1997 Mar; 76(2): F88-93. doi: 10.1136/fn.76.2.f88. PMID: 9135286; PMCID: PMC1720626.
- Leijser LM, Liauw L, Veen S, de Boer IP, Walther FJ, van Wezel-Meijler G. Comparing brain white matter on sequential cranial ultrasound and MRI in very preterm infants. Neuroradiology. 2008 Sep; 50(9): 799-811. doi: 10.1007/s00234-008-0408-4. Epub 2008 Jun 11. PMID: 18545992.
- Leijser LM, de Bruïne FT, Steggerda SJ, van der Grond J, Walther FJ, van Wezel-Meijler G. Brain imaging findings in very preterm infants throughout the neonatal period: part I. Incidences and evolution of lesions, comparison between ultrasound and MRI. Early Hum Dev. 2009 Feb; 85(2): 101-9. doi: 10.1016/j.earlhumdev.2008.11.010. Epub 2009 Jan 13. PMID: 19144474.
- Hsu CL, Lee KL, Jeng MJ, et al. Cranial ultrasonographic findings in healthy full-term neonates: a retrospective review. J Chin Med Assoc. 2012 Aug; 75(8): 389-95. doi: 10.1016/j.jcma.2012.06.007. Epub 2012 Jul 25. PMID: 22901723.
- van Wezel-Meijler G, Steggerda SJ, Leijser LM. Cranial ultrasonography in neonates: role and limitations. Semin Perinatol. 2010 Feb; 34(1): 28-38. doi: 10.1053/j.semperi.2009.10.002. PMID: 20109970.
- Sims ME, Halterman G, Jasani N, Vachon L, Wu PY. Indications for routine cranial ultrasound scanning in the nursery. J Clin Ultrasound. 1986 Jul-Aug; 14(6): 443-7. doi: 10.1002/jcu.1870140607. PMID: 3091644.
- Eze KC, Enukegwu SU. Transfontanelle ultrasonography of infant brain: analysis of findings in 114 patients in Benin City, Nigeria. Niger J Clin Pract .2010 Jun; 13(2): 179-82. PMID: 20499752.
- Nagaraj N, Swami S, Berwal PK, Srinivas A, Swami G. Role of cranial ultrasonography in evaluation of brain injuries in preterm neoanates. Indian Journal of Neonatal Medicine and Research. 2016; 4(2): 5-8.
- Wang LW, Huang CC, Yeh TF. Major brain lesions detected on sonographic screening of apparently normal term neonates. Neuroradiology. 2004 May; 46(5): 368-73. doi: 10.1007/s00234-003-1160-4. Epub 2004 Apr 22. PMID: 15103432.
- Gover A, Bader D, Weinger-Abend M, et al. Head ultrasonograhy as a screening tool in apparently healthy asymptomatic term neonates. Isr Med Assoc J. 2011 Jan; 13(1): 9-13. PMID: 21446229.
- Heibel M, Heber R, Bechinger D, Kornhuber HH. Early diagnosis of perinatal cerebral lesions in apparently normal full-term newborns by ultrasound of the brain. Neuroradiology. 1993; 35(2): 85-91. doi: 10.1007/BF00593960. PMID: 8433799.
- Ballardini E, Tarocco A, Rosignoli C, Baldan A, Borgna-Pignatti C, Garani G. Universal Head Ultrasound Screening in Full-term Neonates: A Retrospective Analysis of 6771 Infants. Pediatr Neurol. 2017 Jun; 71: 14- 7. doi: 10.1016/j.pediatrneurol.2017.03.012. Epub 2017 Mar 30. PMID: 28449983.
- Smith R, Leonidas JC, Maytal J. The value of head ultrasound in infants with macrocephaly. Pediatr Radiol. 1998 Mar; 28(3): 143-6. doi: 10.1007/s002470050315. PMID: 9561530.
- Fernandez Alvarez JR, Amess PN, Gandhi RS, Rabe H. Diagnostic value of subependymal pseudocysts and choroid plexus cysts on neonatal cerebral ultrasound: a meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2009 Nov; 94(6): F443-6. doi: 10.1136/adc.2008.155028. Epub 2009 Mar 25. PMID: 19321510.
- van Baalen A, Versmold H. Anterior choroid plexus cysts: distinction from germinolysis by high-resolution sonography. Pediatr Int. 2008 Feb; 50(1): 57-61. doi: 10.1111/j.1442-200X.2007.02512.x. PMID: 18279206.
- Zielonka-Lamparska E, Wieczorek AP. Usefulness of 3D sonography of the central nervous system in neonates and infants in the assessment of intracranial bleeding and its consequences when examined through the anterior fontanelle. J Ultrason. 2013; 13(55): 408–17.
- Rath C, Suryawanshi P. Point of care neonatal ultrasound—head, lung, gut and line localization. Indian Pediatr. 2016; 53(10): 889–99.
Öz
Amaç: Bu çalışmada, pediatri pratiğinde çeşitli endikasyonlar nedeni ile transfontanel ultrasonografi
(TFUSG) istenilen hastaların tanısal profilinin ortaya çıkarılması hedeflenmiştir.
Gereç ve Yöntem: Bu çalışmada, 01.08.2019-18.10.2021 tarihleri arasında, Balıkesir Üniversitesi Tıp
Fakültesi çocuk sağlığı ve hastalıkları ile çocuk nöroloji polikliniklerinde çeşitli endikasyonlar ile
transfontanel ultrasonografi istenilen 0-2 yaş arasındaki hastaların dosyaları retrospektif olarak
incelendi. TFUSG bulguları normal/normalin varyasyonları ve anormal olarak ikiye ayrıldı.
Bulgular: 77’si (%42,1) kız ve 106’sı (%57,9) erkek olmak üzere toplam 183 olgu çalışmaya dahil
edildi. Olguların yaş ortalaması 119,55±134,52 gün (1-700 gün) idi. En sık TFUSG istem nedenleri;
çeşitli etiyolojiler (n=79, %43,2), nöbet (n=37, %20,2), ve yenidoğan yoğun bakım ünitesine yatış
öyküsü (n=23, %12,6) idi. 30 (%16,4) olguda TFUSG anormal olarak raporlandı. En sık anormal
TFUSG bulguları; beyin omurilik sıvısı (BOS) mesafelerinde genişleme (n=8,%4,4), hidrosefali (n=7,
%3,8), subaraknoid mesafede genişleme (n=5, %2,7) idi. TFUSG normal veya anormal olanlar
arasında cinsiyet, gestasyon yaşına göre doğum ağırlığı ve baş çevresi açısından istatiksel olarak
anlamlı farklılık saptandı (p=0,007, p=0,048, p=0,00).
Sonuç: 0-2 yaş arası hastalarda TFUSG bulgularında cinsiyet, gestasyon yaşına göre doğum ağırlığı
ve baş çevresi açısından anlamlı farklılık saptanması çalışmamızı öne çıkaran özelliktir ve üzerinde
daha kapsamlı çalışılması gereken bir bulgudur.
Anahtar Kelimeler
Kaynakça
- Nzeh DA, Erinle SA, Saidu SA, Pam SD. Transfontanelle ultrasonography: an invaluable tool in the assessment of the infant brain. Trop Doct. 2004 Oct; 34(4): 226-7. doi: 10.1177/004947550403400413. PMID: 15510949.
- Harmat G. Intracranial sonography in infancy. Acta Paediatr Hung. 1985; 26(1): 15-29. PMID: 3885973.
- Dawbury K. Ultrasound of the infant brain. In: Sutton D (ed). Textbook of radiology and imaging 6 th edition. Churchill Livingstone,London; 1998:1651-56.
- Estan J, Hope P. Unilateral neonatal cerebral infarction in full term infants. Arch Dis Child Fetal Neonatal Ed. 1997 Mar; 76(2): F88-93. doi: 10.1136/fn.76.2.f88. PMID: 9135286; PMCID: PMC1720626.
- Leijser LM, Liauw L, Veen S, de Boer IP, Walther FJ, van Wezel-Meijler G. Comparing brain white matter on sequential cranial ultrasound and MRI in very preterm infants. Neuroradiology. 2008 Sep; 50(9): 799-811. doi: 10.1007/s00234-008-0408-4. Epub 2008 Jun 11. PMID: 18545992.
- Leijser LM, de Bruïne FT, Steggerda SJ, van der Grond J, Walther FJ, van Wezel-Meijler G. Brain imaging findings in very preterm infants throughout the neonatal period: part I. Incidences and evolution of lesions, comparison between ultrasound and MRI. Early Hum Dev. 2009 Feb; 85(2): 101-9. doi: 10.1016/j.earlhumdev.2008.11.010. Epub 2009 Jan 13. PMID: 19144474.
- Hsu CL, Lee KL, Jeng MJ, et al. Cranial ultrasonographic findings in healthy full-term neonates: a retrospective review. J Chin Med Assoc. 2012 Aug; 75(8): 389-95. doi: 10.1016/j.jcma.2012.06.007. Epub 2012 Jul 25. PMID: 22901723.
- van Wezel-Meijler G, Steggerda SJ, Leijser LM. Cranial ultrasonography in neonates: role and limitations. Semin Perinatol. 2010 Feb; 34(1): 28-38. doi: 10.1053/j.semperi.2009.10.002. PMID: 20109970.
- Sims ME, Halterman G, Jasani N, Vachon L, Wu PY. Indications for routine cranial ultrasound scanning in the nursery. J Clin Ultrasound. 1986 Jul-Aug; 14(6): 443-7. doi: 10.1002/jcu.1870140607. PMID: 3091644.
- Eze KC, Enukegwu SU. Transfontanelle ultrasonography of infant brain: analysis of findings in 114 patients in Benin City, Nigeria. Niger J Clin Pract .2010 Jun; 13(2): 179-82. PMID: 20499752.
- Nagaraj N, Swami S, Berwal PK, Srinivas A, Swami G. Role of cranial ultrasonography in evaluation of brain injuries in preterm neoanates. Indian Journal of Neonatal Medicine and Research. 2016; 4(2): 5-8.
- Wang LW, Huang CC, Yeh TF. Major brain lesions detected on sonographic screening of apparently normal term neonates. Neuroradiology. 2004 May; 46(5): 368-73. doi: 10.1007/s00234-003-1160-4. Epub 2004 Apr 22. PMID: 15103432.
- Gover A, Bader D, Weinger-Abend M, et al. Head ultrasonograhy as a screening tool in apparently healthy asymptomatic term neonates. Isr Med Assoc J. 2011 Jan; 13(1): 9-13. PMID: 21446229.
- Heibel M, Heber R, Bechinger D, Kornhuber HH. Early diagnosis of perinatal cerebral lesions in apparently normal full-term newborns by ultrasound of the brain. Neuroradiology. 1993; 35(2): 85-91. doi: 10.1007/BF00593960. PMID: 8433799.
- Ballardini E, Tarocco A, Rosignoli C, Baldan A, Borgna-Pignatti C, Garani G. Universal Head Ultrasound Screening in Full-term Neonates: A Retrospective Analysis of 6771 Infants. Pediatr Neurol. 2017 Jun; 71: 14- 7. doi: 10.1016/j.pediatrneurol.2017.03.012. Epub 2017 Mar 30. PMID: 28449983.
- Smith R, Leonidas JC, Maytal J. The value of head ultrasound in infants with macrocephaly. Pediatr Radiol. 1998 Mar; 28(3): 143-6. doi: 10.1007/s002470050315. PMID: 9561530.
- Fernandez Alvarez JR, Amess PN, Gandhi RS, Rabe H. Diagnostic value of subependymal pseudocysts and choroid plexus cysts on neonatal cerebral ultrasound: a meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2009 Nov; 94(6): F443-6. doi: 10.1136/adc.2008.155028. Epub 2009 Mar 25. PMID: 19321510.
- van Baalen A, Versmold H. Anterior choroid plexus cysts: distinction from germinolysis by high-resolution sonography. Pediatr Int. 2008 Feb; 50(1): 57-61. doi: 10.1111/j.1442-200X.2007.02512.x. PMID: 18279206.
- Zielonka-Lamparska E, Wieczorek AP. Usefulness of 3D sonography of the central nervous system in neonates and infants in the assessment of intracranial bleeding and its consequences when examined through the anterior fontanelle. J Ultrason. 2013; 13(55): 408–17.
- Rath C, Suryawanshi P. Point of care neonatal ultrasound—head, lung, gut and line localization. Indian Pediatr. 2016; 53(10): 889–99.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Aralık 2022 |
| Gönderilme Tarihi | 7 Şubat 2022 |
| Yayımlandığı Sayı | Yıl 2022 |