title: Superficial Echogenic Lesions Detected on Neonatal Cranial Sonography: Possible Indicators of Severe Birth Injury.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the characteristics and importance of superficial echogenic lesions around cranial sutures on neonatal cranial sonography.
  
  
  METHODS
  We retrospectively reviewed the clinical records and neuroimaging studies of 40 neonates who had superficial echogenic lesions around sutures on neonatal cranial sonography. Magnetic resonance imaging (n = 18) and computed tomography (n = 2) were performed within 2 weeks after sonography. We correlated sonographic findings with computed tomographic and magnetic resonance imaging findings and analyzed them. We also evaluated the associated lesions, neurologic signs, and follow-up changes.
  
  
  RESULTS
  Sonographically, the superficial echogenic lesions involved both sulci and perisulcal parenchyma in 39 neonates and were located in the frontal and parietal areas around the sagittal suture in 38 neonates. Magnetic resonance imaging revealed a pattern of hypoxic ischemic encephalopathy in 9 neonates, birth trauma in 3 neonates, a mixed pattern of hypoxic ischemic encephalopathy and trauma in 3 neonates, nonspecific single infarctions in 2 neonates, and lack of a defined lesion in 1 neonate. The associated lesions were subdural hemorrhage (n = 12), epidural hematoma (n = 4), germinal matrix hemorrhage (n = 3), intraventricular hemorrhage (n = 2), and periventricular leukomalacia (n = 1). All epidural hematomas were associated with scalp hematoma, and 2 patients had skull fractures. One neonate with epidural hematoma associated with a hypoxic ischemic encephalopathy pattern showed mild spasticity in both ankles until 16 months.
  
  
  CONCLUSIONS
  Superficial echogenic lesions detected around cranial sutures on neonatal sonography may be an indicator of more serious intracranial lesions such as more extensive hypoxic ischemic encephalopathy and intracranial hematomas, including epidural hematoma.
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Byoung Hee
authors.initials: BH
authors.lastname: Han
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.). radsmj@msn.com.
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Song
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Kyung Sang
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Young-Hwa
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Ko
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Goun
authors.initials: G
authors.lastname: Jung
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Sung Bin
authors.initials: SB
authors.lastname: Park
authors.affiliation: Departments of Radiology (B.H.H., M.J.S., K.S.L., Y.-H.K.) and Pediatrics (S.Y.K., G.J.), Dankook University College of Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea; Department of Radiology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (S.B.P.); and Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Sinchon-dong, Seoul, Korea (S.-K.L.).
authors.forename: Seung-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D001720:Birth Injuries / Q000000981:diagnostic imaging*; D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: cranial hematoma; epidural hematoma; hypoxic ischemic encephalopathy; infant; magnetic resonance imaging; neonate; pediatric ultrasound; sonography