Potential pitfalls in cranial sonography.
BACKGROUND
We present several anatomic variants of the brain and artifacts related to scanning techniques which could be misinterpreted as lesions on neonatal cranial sonography.


METHODS
The findings were derived from US studies performed on 176 premature infants and 26 full-term newborns, using the anterior, posterior and mastoid fontanelles as acoustic windows.


RESULTS
The pseudolesions are divided into three groups: ventricular system (asymmetric lateral ventricle size and coarctation of the lateral ventricles); choroid plexus ("split" choroid, "truncated" choroid and choroid cyst); and brain parenchyma (peritrigonal blush, thalamic pseudolesion, pseudo-absence of the inferior vermis, occipital pseudomass and calcar avis simulating intraventricular clot). We provide images of these pseudolesions and clues to their differentiation from true brain pathology. Images of several brain disorders are included for comparison. Knowledge of these potential pitfalls is essential for proper interpretation of US brain studies and will help to avoid the use of other more invasive diagnostic tests.


CONCLUSIONS
Misleading images seen on US examination of the neonatal brain that could be misinterpreted as pathology are presented, with clues to their differentiation from true lesions.
Enríquez
Goya
G
Department of Pediatric Radiology, Hospital Vall d'Hebron, Ps. Vall d'Hebron 119-129, 08035 Barcelona, Spain. enriquez@cs.vhebron.es
Correa
Flavia
F
Lucaya
Javier
J
Piqueras
Joaquim
J
Aso
Celestino
C
Ortega
Aranzazu
A
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000648:ultrastructure; D001927:Brain Diseases / Q000175:diagnosis; D004453:Echoencephalography; D006801:Humans; D017585:Ultrasonography, Doppler, Transcranial / Q000009:adverse effects*