title: Evaluating Affordable Cranial Ultrasonography in East African Neonatal Intensive Care Units.
abstract: Neuroimaging is a valuable diagnostic tool for the early detection of neonatal brain injury, but equipment and radiologic staff are expensive and unavailable to most hospitals in developing countries. We evaluated an affordable, portable ultrasound machine as a quantitative and qualitative diagnostic tool and to establish whether a novice sonographer could effectively operate the equipment and obtain clinically important information. Cranial ultrasonography was performed on term healthy, pre-term and term asphyxiated neonates in Rwandan and Kenyan hospitals. To evaluate the detection of ventriculomegaly and compression injuries, we measured the size of the lateral ventricles and corpus callosum. The images were also assessed for the presence of other cerebral abnormalities. Measurements were reliable across images, and cases of clinically relevant ventriculomegaly were detected. A novice sonographer had good-to-excellent agreement with an expert. This study demonstrates that affordable equipment and cranial ultrasound protocols can be used in low-resource settings to assess the newborn brain.
authors: Anatomy and Cell Biology, Western University, London, Ontario, Canada.
authors: David E
authors: DE
authors: Clay
authors: Brain and Mind Institute, Western University, London, Ontario, Canada. Electronic address: annikalinke@gmail.com.
authors: Annika C
authors: AC
authors: Linke
authors: Brain and Mind Institute, Western University, London, Ontario, Canada.
authors: Daniel J
authors: DJ
authors: Cameron
authors: Brain and Mind Institute, Western University, London, Ontario, Canada.
authors: Bobby
authors: B
authors: Stojanoski
authors: Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda.
authors: Stephen
authors: S
authors: Rulisa
authors: School of Medicine, University of Nairobi, Nairobi, Kenya.
authors: Aggrey
authors: A
authors: Wasunna
authors: Anatomy and Cell Biology, Western University, London, Ontario, Canada; Brain and Mind Institute, Western University, London, Ontario, Canada; Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors: Sandrine
authors: S
authors: de Ribaupierre
authors: Brain and Mind Institute, Western University, London, Ontario, Canada.
authors: Rhodri
authors: R
authors: Cusack
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000000981:diagnostic imaging; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: Birth asphyxia; Cranial ultrasound; Neonatology; Perinatal brain injury; Prematurity; Ventriculomegaly