Cinegraphic versus Combined Static and Cinegraphic Imaging for Initial Cranial Ultrasound Screening in Premature XXXX .

@entity1 @entity548 @entity16 @entity1188 @entity5719 @entity45 @entity385
BACKGROUND: Cranial ultrasound is an essential screening and diagnostic tool in the care of neonates and is especially useful in the premature population for evaluation of potential germinal matrix/ @entity548 (GM/IVH). There are typically two screening examinations, with the initial cranial sonography performed between 3 days and 14 days after birth, usually consisting of a series of static images plus several cinegraphic sweeps. OBJECTIVE: Our primary goal was to assess whether cinegraphic sweeps alone are as accurate for diagnosing @entity16 as combined static and cinegraphic imaging in the initial cranial US evaluation of premature @entity1 . Our secondary goal was to establish the difference in time required to perform these two examinations. MATERIALS AND METHODS: We retrospectively obtained 140 consecutive initial cranial US screening studies of premature @entity1 . Three pediatric radiologists blinded to @entity1 data read cinegraphic images alone and also combined (dual) imaging sets for a subset of subjects, recording findings for seven disease processes: germinal matrix/ @entity548 (GM/IVH), right or left side; @entity5719 ( @entity5719 ); choroid plexus cyst; @entity385 or @entity548 ; posterior fossa @entity548 or @entity1188 , and extra-axial @entity548 . Separately, we compared retrospective dual imaging acquisition time against prospectively collected cinegraphic imaging time for premature @entity1 undergoing initial cranial US evaluation. RESULTS: Equivalence testing demonstrated no difference in equivalency between initial cranial US screening using cinegraphic evaluation alone and dual imaging for GM/IVH, cerebral and cerebellar @entity385 , and @entity45 (all P   <   0.05). For @entity5719 and choroid plexus cyst, cinegraphic imaging and dual imaging did not demonstrate equivalence (P   >   0.05). Cinegraphic images were obtained in less than one-third of the time required for dual imaging. CONCLUSION: For the diagnoses that are critical to establish at initial screening (GM/IVH, cerebral and cerebellar @entity385 ) initial cranial US screening using cinegraphic sweeps was equivalent to dual imaging. Cinegraphic imaging required significantly less time to perform than dual imaging. We suggest that performance of cranial US screening using cinegraphic imaging alone is a potentially advantageous option in the initial evaluation of the premature neonate.
