Neonatal intracranial ischemia and hemorrhage: diagnosis with US, CT, and MR imaging.
OBJECTIVE
To assess the usefulness of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging in the detection of intracranial hemorrhage and ischemia in newborns.


METHODS
Seventy-six neonates who underwent US within 72 hours of CT or MR examination were studied. Four observers rated images for the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IPH), extraaxial hemorrhage, and hypoxic-ischemic encephalopathy.


RESULTS
In 39% of neonates, CT and MR imaging provided greater confidence than US for the diagnosis or exlusion of neonatal ischemia or hemorrhage. Kappa analysis revealed significantly better interobserver agreement with CT than with US for the detection of GMH, IVH, IPH, and cortical infarction or ischemia (P <.005). Interobserver agreement was significantly better with MR imaging than with US for the detection of GMH, IVH, and cortical infarction or ischemia (P < .005).


CONCLUSIONS
Sensitivity and interobserver agreement are better with MR imaging and CT than with US for the detection of neonatal cortical ischemia or infarction.
Blankenberg
F G
FG
Department of Radiology, Stanford University Hospital, Calif, USA.
Norbash
A M
AM
Lane
B
B
Stevenson
D K
DK
Bracci
P M
PM
Enzmann
D R
DR
D001034:Apgar Score; D001724:Birth Weight; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity