title: Color Doppler US of normal cerebral venous sinuses in neonates: a comparison with MR venography.
abstract: BACKGROUND
  Color Doppler US (CDUS) has been used for evaluation of cerebral venous sinuses in neonates. However, there is very limited information available regarding the appearance of superficial and deep normal cerebral venous sinuses using CDUS and the specificity of the technique to rule out disease.
  
  
  OBJECTIVE
  To determine the specificity, inter-modality and inter-reader agreement of color Doppler US (CDUS). To evaluate normal cerebral venous sinuses in neonates in comparison to MR venography (MRV).
  
  
  METHODS
  Newborns undergoing a clinically indicated brain MRI were prospectively evaluated. All underwent a dedicated CDUS of the cerebral venous sinuses within 10 h (mean, 3.5 h, range, and 2-7.6 h) of the MRI study using a standard protocol.
  
  
  RESULTS
  Fifty consecutive neonates participated in the study (30 males [60%]; 25-41 weeks old; mean, 37 weeks). The mean time interval between the date of birth and the CDUS study was 19.1 days. No cases showed evidence of thrombosis. Overall agreement for US reading was 97% (range, 82-100%), for MRV reading, 99% (range, 96-100%) and for intermodality, 100% (range, 96-100%). Excellent US-MRI agreement was noted for superior sagittal sinus, cerebral veins, straight sinus, torcular Herophili, sigmoid sinus, superior jugular veins (94-98%) and transverse sinuses (82-86%). In 10 cases (20%), MRV showed flow gaps whereas normal flow was demonstrated with US. Visualization of the inferior sagittal sinus was limited with both imaging techniques.
  
  
  CONCLUSIONS
  Excellent reading agreement was noted for US, MRV and intermodality. CDUS is highly specific to rule out cerebral venous thrombosis in neonates and holds potential for clinical application as part of clinical-laboratory-imaging algorithms of pre/post-test probabilities of disease.
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada. elkaavimiller@gmail.com
authors.forename: Elka
authors.initials: E
authors.lastname: Miller
authors.forename: Alan
authors.initials: A
authors.lastname: Daneman
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Doria
authors.forename: Susan
authors.initials: S
authors.lastname: Blaser
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Traubici
authors.forename: Jose
authors.initials: J
authors.lastname: Jarrin
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.forename: Aideen
authors.initials: A
authors.lastname: Moore
authors.forename: Manohar
authors.initials: M
authors.lastname: Shroff
mesh_terms: D003392:Cranial Sinuses / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015588:Observer Variation; D010690:Phlebography / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*