ABSTRACT
Spinal dysraphism refers to abnormalities with imperfect fusion of midline neural and bony structures of the spine. It is the most common congenital central nervous system abnormality, with myelomeningoceles occurring in up to 2 per 1000 live births. Aim of the work: this study aimed to assess the diagnostic value of spinal ultrasonography in pediatrics patients with spinal dysraphism. This study was carried out on 30 infants with clinically diagnosed or suspected spinal dysraphism who were referred by the Neurosurgery Department or outpatient clinic to the Radiology Department at Alexandria University Hospital over the period from May 2004 to April 2005. Ultrasonography findings were correlated with those of MRL The degree of agreement between both modalities was determined and rated as full, partial, or no consensus. Total consensus was achieved in 24 of 30 examinations. Partial consensus was achieved in six examinations with US showing main spinal anomaly but not additional details depicted by MRL There was ho significant difference between US and MRl results in diagnosing of the main spinal anomalies. So we concluded that ultrasound is a valuable tool for the diagnosis of congenital malformations in infancy especially in patients younger than six months of age
Subject(s)
Humans , Male , Female , Infant, Newborn , Ultrasonography , Magnetic Resonance Imaging , Lumbosacral RegionABSTRACT
We evaluated the role of transcranial color Doppler sonography in diagnosis of cerebrovascular lesions. This study was conducted on 40 subjects, 15 were normal healthy volunteers as control and 25 were patients with clinical and radiological diagnosis of cerebrovascular lesions. All subjects underwent sonographic examination of the brain parenchyma and major intracranial cerebral arteries namely anterior, middle and posterior cerebral arteries via temporal acoustic window with a 2.8-MHz transducer. Major intracranial arteries were examined bilaterally by color flow imaging, and angle-corrected blood flow velocities were determined with integrated pulse wave [PW] Doppler. This study was conducted on 40 subjects, [22 males and 18 females], 15 were normal healthy volunteers as control and 25 were patients with clinical and radiological diagnosis of cerebrovascular lesions. There were ten cases of failed study, five from the control group and five from patients group. The remaining subjects with good acoustic temporal bone window were thirty, twenty from the patients group and ten from the control group. There were twenty patients with cerebrovascular lesions radiologically diagnosed as seven ischemic stroke, four hemorrhage stroke, one brain tumor, five intracerberal aneurysms, and three intracerebral arteriovenous malformations [AVM]. In stroke patients, four patients with intracerebral hematoma [ICH] and three with ischaemic stroke showed no changes in transcranial color coded sonography [TCCS], while four patients with ischemic stroke showed dynamic changes in the ipsilateral middle cerebral artery manifested as increased flow in one patient, creased flow in 2 patients and occluded Ml segment in one patient. The case with decreased flow, showed evidence of cross flow from the contralateral side through the anterior communicating artery [ACoA] shown as reversal in color and direction of flow in the ipsilateral middle cerebral artery [MCA] due to complete occlusion in the ipsilateral internal carotid artery seen in carotid Doppler sonography. The case with CT diagnosis as brain tumor was diagnosed by transcranial color coded sonography [TCCS] as intracranial space occupying mass lesion. the five patients with angiographically proven as intracerebral aneurysms, transcranial color coded sonography [TCCS] revealed only three cases through the temporal bone with mean diameter more than 5 mm. two small aneurysms less than 5 mm were missed. One of the three patients with angiographically proven intracrebral AVM was missed by transcranial color coded sonography [TCCS]. Transcranial Color sonography also revealed hemodynamic changes in the feeder arteries as increased. Peak systolic [PS] and end diastolic [ED] velocities, while the resistive index [RI] and pulsatility index [PI] were decreased. Transcranial color-coded sonography [TCCS] combines non-invasive imaging of intracranial vessels and parenchymal structures at a high spatial resolution in different intracranial vascular lesions