- Patient preparation: none
- Contrast used: none
- Technique:
— Review previous exams if available
— Check transducer left / right orientation
— Scan through the anterior fontanelle
— Fill screen with image by varying the depth – use the 4th ventricle image for this - Images to obtain:
— Coronal:
— 1st – Through the orbits
— 2nd – Star image (pentagon sign) through the Circle of Willis
— 3rd – 3rd ventricle
— 4th – 4th ventricle (check this image first to set depth)
— 5th – Choroid plexus
— 6th – Over the top of (posterior to) the lateral ventricles
— Sagittal:
— 1st – Midline
— 2nd – Left of midline through lateral ventricle
— 3rd – Even more left of midline through the Sylvian fissure
— 4th – Midline
— 5th – Right of midline through lateral ventricle
— 6th – Even more right of midline through the Sylvian fissure
— Take additional images of any pathology you see - Looking for:
— In premature infant – germinal matrix hemorrhage, intraventricular hemorrhage, intraparenchymal hemorrhage, periventricular leukomalacia, edema, ventricular dilation
— In term infant – hydrocephaleus or enlarged subarachnoid space
— In pre-ECMO patient – intracranial developmental abnormality, pre-existing intracranial bleed
— In ECMO patient – intraparenchymal hemorrhage, subdural hematoma, cerebral atrophy - Post procedure tasks: none
Pediatric Imaging 