title: Transfontanellar contrast enhanced ultrasound in infants: initial experience.
abstract: OBJECTIVE
  Transfontanellar contrast enhanced ultrasound (TCEUS) in infants with neurological diseases has not been previously reported. Thus, the objective of our study was to describe the imaging findings of transfontanellar contrast enhanced ultrasound (TCEUS) performed in various neurological conditions in infants and to compare the findings with non-enhanced transfontanellar ultrasound (TFUS) and MRI.
  
  
  METHODS
  Local institutional review board approval was obtained and, because of the need to catheterize children for contrast media administration, written informed consent of parents was obtained prior to all performed TCEUS. Twelve infants who underwent 12 TCEUS were included in this study from June 2009 to June 2012. Second generation contrast material was used (Bracco). TCEUS imaging findings were compared with those of conventional transfontanellar ultrasound in each case and with MRI.
  
  
  RESULTS
  In 10 out of the 12 performed examinations, TCEUS showed abnormalities which were not depicted on non-enhanced TFUS. Accurate diagnosis of TCEUS compared with MRI was found in 10 out of 12 initial TCEUS. No adverse events during or immediately after contrast media injection occurred.
  
  
  CONCLUSIONS
  TCEUS appears to be a potential bedside accessible non-ionizing alternative imaging modality in the assessment of neonatal brain injury. It provides additional information when compared to non-enhanced transfontanellar US, especially in the field of brain perfusion assessment. Moreover, the information provided seems to be accurate when compared with those of MRI.
authors.affiliation: Neuroradiology Unit, CLUNI, Grenoble University Hospital, Grenoble, France; I4S Laboratory - EA 4268_IFR133, Franche Comté University, Besançon, France. Electronic address: adriankastler@gmail.com.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kastler
authors.affiliation: Radiology and Interventional Pain Management Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Manzoni
authors.affiliation: Radiology and Interventional Pain Management Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Chapuy
authors.affiliation: Neuroradiology and Vascular Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Cattin
authors.affiliation: Neuroradiology and Vascular Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Clélia
authors.initials: C
authors.lastname: Billon-Grand
authors.affiliation: I4S Laboratory - EA 4268_IFR133, Franche Comté University, Besançon, France; Radiology and Interventional Pain Management Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Aubry
authors.affiliation: Neuroradiology and Vascular Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Neonatal Intensive Care Unit, University Hospital St-Jacques, Besançon, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiriez
authors.affiliation: I4S Laboratory - EA 4268_IFR133, Franche Comté University, Besançon, France; Radiology and Interventional Pain Management Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Kastler
mesh_terms: D001930:Brain Injuries / Q000000981:diagnostic imaging*; D003287:Contrast Media; D055762:Cranial Fontanelles / Q000000981:diagnostic imaging* / Q000293:injuries*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: Contrast; Ischemia; Newborn; Safety; Transfontanellar ultrasound