Color Doppler US of normal cerebral venous sinuses in neonates: a comparison with MR venography

• DOI: 10.1007/s00247-012-2393-3
• Publication Date: 2012-04-24T14:38:04Z
• Authors: Elka Miller; Alan Daneman; Andrea S. Doria; Susan Blaser; Jeffrey Traubici; Jose Jarrin; Rahim Moineddin; Aideen Moore; Manohar Shroff
• Keywords: Male; Observer Variation; Infant, Newborn; Reproducibility of Results; Phlebography; Cranial Sinuses; Magnetic Resonance Imaging; Sensitivity and Specificity; 03 medical and health sciences; 0302 clinical medicine; Reference Values; Humans; Ultrasonography, Doppler, Color

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.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).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.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.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.