Usefulness of Cranial Ultrasound for Detecting Neonatal Middle Cerebral Artery Stroke
Magnetic resonance imaging is the gold standard technique in establishing the diagnosis of neonatal arterial ischemic stroke (NAIS). The diagnostic value of cranial ultrasound scanning in this clinical context is controversial. We aimed to assess the current sensitivity of the cranial ultrasound sca...
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Published in | Ultrasound in medicine & biology Vol. 45; no. 3; pp. 885 - 890 |
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Language | English |
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Elsevier Inc
01.03.2019
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Abstract | Magnetic resonance imaging is the gold standard technique in establishing the diagnosis of neonatal arterial ischemic stroke (NAIS). The diagnostic value of cranial ultrasound scanning in this clinical context is controversial. We aimed to assess the current sensitivity of the cranial ultrasound scan (CUS) in detecting NAIS, as this issue has not been well described in the literature. Newborns with NAIS diagnosed by magnetic resonance imaging between 2010 and 2016 were included. All CUSs were blindly analyzed retrospectively by a neonatologist expert in neuroimaging and compared with the findings of non-expert evaluators recorded on medical charts immediately after performing the evaluation. The overall sensitivity of CUS in detecting an imaging finding suggestive of NAIS was 87% (95% confidence interval (CI): 79%–95%) for an expert evaluator, but declined to 72% (61%–83%) when performed by a non-expert evaluator (p 0.002). Sensitivity was 83% and 61% in the first 24 h and 86% and 66% at 24–48 h for expert and non-expert evaluators, respectively (p < 0.05). CUS has higher sensitivity than previously reported in the detection of a NAIS, for both expert and non-expert evaluators. These findings may be explained by the advanced technology of new ultrasound equipment. Expertise in performing CUS is useful, particularly in the first 48 h after clinical debut. |
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AbstractList | Magnetic resonance imaging is the gold standard technique in establishing the diagnosis of neonatal arterial ischemic stroke (NAIS). The diagnostic value of cranial ultrasound scanning in this clinical context is controversial. We aimed to assess the current sensitivity of the cranial ultrasound scan (CUS) in detecting NAIS, as this issue has not been well described in the literature. Newborns with NAIS diagnosed by magnetic resonance imaging between 2010 and 2016 were included. All CUSs were blindly analyzed retrospectively by a neonatologist expert in neuroimaging and compared with the findings of non-expert evaluators recorded on medical charts immediately after performing the evaluation. The overall sensitivity of CUS in detecting an imaging finding suggestive of NAIS was 87% (95% confidence interval (CI): 79%-95%) for an expert evaluator, but declined to 72% (61%-83%) when performed by a non-expert evaluator (p 0.002). Sensitivity was 83% and 61% in the first 24 h and 86% and 66% at 24-48 h for expert and non-expert evaluators, respectively (p < 0.05). CUS has higher sensitivity than previously reported in the detection of a NAIS, for both expert and non-expert evaluators. These findings may be explained by the advanced technology of new ultrasound equipment. Expertise in performing CUS is useful, particularly in the first 48 h after clinical debut. |
Author | Echeverría-Palacio, Carlos Mario García-Alix, Alfredo Agut, Thais Arca, Gemma Olivé, Gemma |
Author_xml | – sequence: 1 givenname: Gemma surname: Olivé fullname: Olivé, Gemma organization: Department of Neonatology, Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain – sequence: 2 givenname: Thais orcidid: 0000-0002-5673-0016 surname: Agut fullname: Agut, Thais email: tagut@sjdhospitalbarcelona.org organization: Department of Neonatology, Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain – sequence: 3 givenname: Carlos Mario surname: Echeverría-Palacio fullname: Echeverría-Palacio, Carlos Mario organization: Research Group “Neuroped-UNAL,” School of Medicine, Universidad Nacional de Colombia, Bogotá, Columbia – sequence: 4 givenname: Gemma surname: Arca fullname: Arca, Gemma organization: Department of Neonatology, Agrupació Sanitaria Hospital Clinic, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain – sequence: 5 givenname: Alfredo surname: García-Alix fullname: García-Alix, Alfredo organization: Department of Neonatology, Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain |
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Cites_doi | 10.1016/j.mric.2011.10.001 10.1542/peds.105.3.e42 10.1136/adc.2004.055558 10.1177/08830738030180021401 10.1007/s00247-015-3357-1 10.1136/fn.73.2.F67 10.1212/CPJ.0000000000000077 10.3171/jns.1981.54.2.0151 10.1016/j.pediatrneurol.2017.01.014 |
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Keywords | Cranial ultrasound Sensitivity Neonate Neonatal arterial ischemic stroke |
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SubjectTerms | Cranial ultrasound Echoencephalography Female Humans Infant, Newborn Infarction, Middle Cerebral Artery - diagnostic imaging Male Middle Cerebral Artery - diagnostic imaging Neonatal arterial ischemic stroke Neonate Prospective Studies Retrospective Studies Sensitivity |
Title | Usefulness of Cranial Ultrasound for Detecting Neonatal Middle Cerebral Artery Stroke |
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