Radiology, Vol 149, 111-116, Copyright © 1983 by Radiological Society of North America
Cranial computed tomography and real-time sonography in full-term neonates and infants
MJ Siegel, J Patel, MH Gado and GD Shackelford
The results of cranial ultrasonography (US) and computed tomography (CT)
were compared in 52 full-term neonates and young infants. The chief
indications for examination included: increasing head size, dysmorphic
features, myelomeningocele, inflammatory disease, and asphyxia. Disorders
detected included hydrocephalus, parenchymal abnormalities, intracranial
hemorrhage, extraparenchymal fluid collections, and vascular and other
developmental malformations. Hydrocephalus and subdural collections were
seen in patients referred for all clinical indications, whereas diffuse
parenchymal abnormalities, subarachnoid hemorrhage, and intraventricular
hemorrhage occurred primarily in patients with hypoxia. CT and US
essentially were equivalent in detecting hydrocephalus, moderate to large
intraventricular hemorrhages or subdural collections, and large focal
parenchymal lesions, although CT was somewhat better in determining the
level and cause of obstruction in patients with hydrocephalus and
characterizing parenchymal abnormalities. CT was more sensitive than
ultrasound in detecting subarachnoid hemorrhage (100% vs. 0%), diffuse
parenchymal abnormality (100% vs. 33%), and small intraventricular
hemorrhages (100% vs. 0%) but these lesions often were not clinically
significant. The results suggest that US should be used as the primary
neuroradiological examination in term infants; CT probably should be
reserved for further investigation after US in those patients with a
history of hypoxia and progressive clinical deterioration.
