Can you ultrasound the brain?

Canine Neonatal Transcranial Ultrasonography from Birth Until Closure of Bregmatic Fontanelle

Hassan et al

Background: Ultrasonography is a valuable diagnostic tool for assessing neonatal brain structures in both humans and canines. Unlike magnetic resonance imaging (MRI) and computed tomography (CT), ultrasonography is cost-effective, does not require anesthesia, and provides real-time imaging. This study aimed to describe the sequential ultrasonographic appearance of the normal canine neonatal brain from birth until closure of the bregmatic fontanelle, establishing a reference for diagnosing congenital brain diseases.

Methods: Sixteen clinically normal neonatal dogs of mixed breeds were examined using transcranial ultrasonography at 3, 10, 20, and 30 days of age. The bregmatic fontanelle served as an acoustic window for obtaining five scan planes: three transverse, one sagittal, and one parasagittal. Imaging was performed using an 8–10 MHz linear transducer. The anatomical structures were assessed for echogenicity and developmental differentiation.

Results: The study successfully documented the developmental changes in neonatal brain ultrasonography. Good-quality images were obtained at 10 and 20 days, while images at 3 days had poor differentiation, and at 30 days, details were lost due to fontanelle closure. The caudate nucleus, thalamus, corpus callosum, and lateral ventricles were identified in transverse scans. Sagittal and parasagittal scans revealed additional structures such as the cerebellum and brainstem. Echogenicity and structural clarity improved with age. In 25% of puppies, transducer pressure caused mild discomfort, which resolved shortly after the examination.

Limitations: The study used a small sample size limited to normocephalic breeds, restricting its applicability to brachycephalic and dolichocephalic breeds. No autopsy validation of ultrasonographic findings was performed. Additionally, the use of a linear transducer instead of microconvex or ophthalmic transducers reduced the number of image planes captured.

Conclusions: This study establishes a baseline for neonatal canine brain ultrasonography until 30 days of age, aiding in the diagnosis of congenital brain disorders such as hydrocephalus. The bregmatic fontanelle provides a viable acoustic window for sonographic examination in neonates, but its utility diminishes as it closes. Further studies should explore differences across skull conformations and utilize more advanced ultrasound transducers for enhanced imaging.

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