Ultra-sonografia cerebral em crianças no primeiro ano de vida: método para o diagnóstico e acompanhamento das dilatações ventriculares

Machado, Hélio Rubens; Machado, José Cassiano; Contrera, José Domingos; Assirati Junior, João Alberto; Martelli, Nelson

doi:10.1590/S0004-282X1982000400010

Resumos

Os autores expõem a experiência adquirida com a utilização da ultra-sonografia (Modo-B e real-time) na avaliação de crianças com afecções neurológicas durante o primeiro ano de vida. A rapidez com que o exame é realizado (20 minutos), seu baixo custo, a desnecessidade de sedação e ausência de irradiação e o fato de ser um exame dinâmico tornam esta técnica útil, mesmo quando comparado com a Tomografia Computadorizada. Seu valor maior está na análise, diagnóstico e acompanhamento dos hidrocéfalos, embora sua utilização se estenda a outros diagnósticos dentro da faixa etária estabelecida.

The ultrasonography (Mode B - Real Time) experience was analyzed to evaluate neurological diseases in children during their first year of life. Forty-two examination were accomplished in twenty-eight children with the following diagnosis: hydrocephalus (22), normal (15), subdural hygroma (3), intracranial cyst and hydrocephalus (1), giant encephalocele (1). The technique consists of positioning the transducer in the coronal, sagital and axial direction and selecting dynamically the images to be photographed. In the coronal position, the height of the lateral ventricle and the width of the third ventricule were obtained. In the axial position, the ventricular ratio-lateral ventricle width cerebral hemisphere width was obtained. Although it was a small group of patients, those indexes can objectify the ventricular size variation in children with well or poor functioning shunts. The importance of this method was the possibility to follow the development of hydrocephalus in cases of myelomeningocele and to analyze the etiology and features of hydrocephalus with or without shunts. In conclusion, this test is very usefull, mainly because it is very brief (about 20 minutes), the patient does not need sedation, it is innocuous, very precise even when compared with computarized tomography and for its low cost.

Ultra-sonografia cerebral em crianças no primeiro ano de vida: método para o diagnóstico e acompanhamento das dilatações ventriculares

Cerebral ultrasonography in children in the first year of life: a method for diagnosis and follow-up of ventricular dilation

Hélio Rubens Machado^I; José Cassiano Machado^I; José Domingos Contrera^I; João Alberto Assirati Junior^I; Nelson Martelli^II

^IMédicos Assistentes do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (USP), Disciplinas de Neurocirurgia e de Radiologia

^IIProfessor Assistente da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Disciplina de Neurocirurgia

RESUMO

Os autores expõem a experiência adquirida com a utilização da ultra-sonografia (Modo-B e real-time) na avaliação de crianças com afecções neurológicas durante o primeiro ano de vida. A rapidez com que o exame é realizado (20 minutos), seu baixo custo, a desnecessidade de sedação e ausência de irradiação e o fato de ser um exame dinâmico tornam esta técnica útil, mesmo quando comparado com a Tomografia Computadorizada. Seu valor maior está na análise, diagnóstico e acompanhamento dos hidrocéfalos, embora sua utilização se estenda a outros diagnósticos dentro da faixa etária estabelecida.

SUMMARY

The ultrasonography (Mode B - Real Time) experience was analyzed to evaluate neurological diseases in children during their first year of life. Forty-two examination were accomplished in twenty-eight children with the following diagnosis: hydrocephalus (22), normal (15), subdural hygroma (3), intracranial cyst and hydrocephalus (1), giant encephalocele (1). The technique consists of positioning the transducer in the coronal, sagital and axial direction and selecting dynamically the images to be photographed. In the coronal position, the height of the lateral ventricle and the width of the third ventricule were obtained. In the axial position, the ventricular ratio-lateral ventricle width cerebral hemisphere width was obtained. Although it was a small group of patients, those indexes can objectify the ventricular size variation in children with well or poor functioning shunts. The importance of this method was the possibility to follow the development of hydrocephalus in cases of myelomeningocele and to analyze the etiology and features of hydrocephalus with or without shunts. In conclusion, this test is very usefull, mainly because it is very brief (about 20 minutes), the patient does not need sedation, it is innocuous, very precise even when compared with computarized tomography and for its low cost.

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Full text available only in PDF format.

Departamento de Cirurgia, Ortopedia e Traumatologia (Área de Neurocirurgia) - Hospital das Clínicas - Campus - 14100 Ribeirão Preto, SP - Brasil.

1. ALBRIGHT, L. & FELLOWS, R. - Sequential CT scanning after neonatal intracerebral hemorrhage. Amer. J. Neuroradiology 2:133, 1981.
2. BABCOCK, D. S. & HAN, B. K. - Cranial sonographic findings in meningomyelocele. Amer. J. Neuroradiology 1:493, 1980.
3. BABCOCK, D. S. & HAN, B. K. - The accuracy of high resolution: real-time ultrasonography of the head in infancy. Radiology 139:665, 1981.
4. DEWBURY, K. C. & ALUWIHARE, A. P. R. - The anterior fontanelle as an ultrasound window for study of the brain: a preliminary report. British J. Radiology 53:81, 1980.
5. EDWARDS, M. K.; BROWN, D. L.; MULLER, J.; GROSSMAN, C. B.; & CHUA, G. T. - Cribside neurosonography: real time sonography for intracranial investigation of the neonate. Amer. J. Neuroradiology 1:501, 1980.
6. FLEISCHER. A. C: HUTCHISON, A. A.; ALLEN, J. H.; STAHLMAN, M. T.; MEACHAM, W. F.; & JAMES, A. E. JR. - The role of sonography and the radiologist-ultrasonologist in the detection and follow-up of intracranial in the preterm neonate. Radiology 139:733, 1981.
7. GARRETT, W. J.; KOSSOFF, G. & WARREN. P. S. - Cerebral ventricular size in children. Radiology 136:711, 1980.
8. GORDON, D. - Echo-encephalography: ultrasonic rays in diagnostic radiology. British Medical J. 3:1500, 1959.
9. GRANT, E. G.; BORTS, F. T.; SCHELLINGER, D.; McCULLOUGH, D. C; SIVASUBRAMANIAN, K. N. & SMITH, Y. - Real-time ultrasonography of neonatal intraventricular hemorrhage and comparison with computed tomography. Radiology 139:687, 1981.
10. GRANT, E. G.; SCHELLINGER, D.; BORTS, F.; McCULLOUGH, D. C: FRIEDMAN, G. R.; SIVASUBRAMANIAN, K, N, & SMITH, Y. - Real-time sonography of the neonatal and infant head. Amer. J. of Neuroradiology 1:487, 1980.
11. HABER, K.; WACHTER, R. D.; CHRSTENSON. P. C; VAUCHER, Y;; SAHN, D. J. & SMITH, J. R. - Ultrasonic evaluation of intracranial pathology in infants-a new technique. Radiologoy 134:173, 1980.
12. JOHNSON, M. L.; MACK, L. A.; RUMACH, C. M.; FROST, M. & RASHBAUM, C. - B-mode echoencephalography in the normal and high risk infant. Amer. J. Roentgenology 133:375, 1979.
13. JOHNSON, M. L. & RUMACK, C. M. - Ultrasonic evaluation of the neonatal brain. Radiologic Clinics of North America. 18:117, 1980.
14. MACK, L.; RUMACK, C. M. & JOHNSON, M. L. - Ultrasound evaluation of cysts and intracranial lesions in the neonate. Radiology 137:451, 1980.
15. SAVERBREI, E. E.; DIGNEY, M.; HARRISON, P. B. & COOPERBERG. P. L. - Ultrasonic evaluation of neonatal intracranial hemorrhage and its complications. Radiology 139:677, 1981.
16. SCHIEFER. W.; KAZNER, E. & KUNZE, S. - Clinical Echo-encefalography Ed. Cientifico-Médica, Barcelona, 1973.
17. SLOVIS, T. L. & KUHNS, L. R. - Real-time sonography of the brain through the anterior fontanelle, Amer. J. Roentgenology 136:277. 1981.

Datas de Publicação

Publicação nesta coleção
15 Ago 2012
Data do Fascículo
Dez 1982

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALBRIGHT, L. & FELLOWS, R. - Sequential CT scanning after neonatal intracerebral hemorrhage. Amer. J. Neuroradiology 2:133, 1981.

[2] 2. BABCOCK, D. S. & HAN, B. K. - Cranial sonographic findings in meningomyelocele. Amer. J. Neuroradiology 1:493, 1980.

[3] 3. BABCOCK, D. S. & HAN, B. K. - The accuracy of high resolution: real-time ultrasonography of the head in infancy. Radiology 139:665, 1981.

[4] 4. DEWBURY, K. C. & ALUWIHARE, A. P. R. - The anterior fontanelle as an ultrasound window for study of the brain: a preliminary report. British J. Radiology 53:81, 1980.

[5] 5. EDWARDS, M. K.; BROWN, D. L.; MULLER, J.; GROSSMAN, C. B.; & CHUA, G. T. - Cribside neurosonography: real time sonography for intracranial investigation of the neonate. Amer. J. Neuroradiology 1:501, 1980.

[6] 6. FLEISCHER. A. C: HUTCHISON, A. A.; ALLEN, J. H.; STAHLMAN, M. T.; MEACHAM, W. F.; & JAMES, A. E. JR. - The role of sonography and the radiologist-ultrasonologist in the detection and follow-up of intracranial in the preterm neonate. Radiology 139:733, 1981.

[7] 7. GARRETT, W. J.; KOSSOFF, G. & WARREN. P. S. - Cerebral ventricular size in children. Radiology 136:711, 1980.

[8] 8. GORDON, D. - Echo-encephalography: ultrasonic rays in diagnostic radiology. British Medical J. 3:1500, 1959.

[9] 9. GRANT, E. G.; BORTS, F. T.; SCHELLINGER, D.; McCULLOUGH, D. C; SIVASUBRAMANIAN, K. N. & SMITH, Y. - Real-time ultrasonography of neonatal intraventricular hemorrhage and comparison with computed tomography. Radiology 139:687, 1981.

[10] 10. GRANT, E. G.; SCHELLINGER, D.; BORTS, F.; McCULLOUGH, D. C: FRIEDMAN, G. R.; SIVASUBRAMANIAN, K, N, & SMITH, Y. - Real-time sonography of the neonatal and infant head. Amer. J. of Neuroradiology 1:487, 1980.

[11] 11. HABER, K.; WACHTER, R. D.; CHRSTENSON. P. C; VAUCHER, Y;; SAHN, D. J. & SMITH, J. R. - Ultrasonic evaluation of intracranial pathology in infants-a new technique. Radiologoy 134:173, 1980.

[12] 12. JOHNSON, M. L.; MACK, L. A.; RUMACH, C. M.; FROST, M. & RASHBAUM, C. - B-mode echoencephalography in the normal and high risk infant. Amer. J. Roentgenology 133:375, 1979.

[13] 13. JOHNSON, M. L. & RUMACK, C. M. - Ultrasonic evaluation of the neonatal brain. Radiologic Clinics of North America. 18:117, 1980.

[14] 14. MACK, L.; RUMACK, C. M. & JOHNSON, M. L. - Ultrasound evaluation of cysts and intracranial lesions in the neonate. Radiology 137:451, 1980.

[15] 15. SAVERBREI, E. E.; DIGNEY, M.; HARRISON, P. B. & COOPERBERG. P. L. - Ultrasonic evaluation of neonatal intracranial hemorrhage and its complications. Radiology 139:677, 1981.

[16] 16. SCHIEFER. W.; KAZNER, E. & KUNZE, S. - Clinical Echo-encefalography Ed. Cientifico-Médica, Barcelona, 1973.

[17] 17. SLOVIS, T. L. & KUHNS, L. R. - Real-time sonography of the brain through the anterior fontanelle, Amer. J. Roentgenology 136:277. 1981.