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Sonographic Evaluation of Cerebral Developement of the Newborn Infant : |
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YS LEE YS Lee, JY Lee, SC Kim, SJ Kim, JH Kim |
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Department of Radiology, College of Medicine, Dankook University *Department of Radiology,Gachon Medical Shool, Gil Medical Center |
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PURPOSE : To ascertain the sonographic changes of cerebral development in the newborn infant according to the
postconceptional age and to assess the sonographic predictability of postconceptional age.
MATERIALS and METHODS : Retrospectively, 251 consecutive normal brain sonograms were analyzed. The postcon-ceptional
age of the newborn infant ranged from 26 to 44 weeks(male : 123, female : 128). We made a score
with sonographic patterns of the sylvian fissure, the sulcal development, the echogenecity of periventricular
white matter(PVWM), and the cortex-subcortex(C-SC) differentiation. The scoring systems were as followed;
Open Y-shape(a point) and close Y-shape(two points) of the sylvian fissure : Lissencephalic pattern(a points),
intermediate pattern(two points), and mature form (three points) of the sulcus : Discrete increased echogenecity
of PVWM along the entire lateral ventriclular wall (a point), indistinct margin and intermediate extent (two
points), and faintly localized to trigonal area(three points) of PVWM echogenicity : Indistinct (a point), broad
and faint (two points), and defintiely linear (three points) C-SC differentiation. We identified the sonographic
developmental change according to postconceptional age. And we classified the maturity of brain with 15
grades using the sonographic score. Correlation between the sonographic grades for cerebral development and
the postconceptional age were statistically analysed.
RESULTS : Sonography showed immature brain(score 1 for sylvian fissure, sulcal pattern, echogenecity of PVWM,
and C-SC differentiation) until 28 postconceptional weeks(PCW) of the newborn infant. All sylvian fissures had
been converted to close Y-shape until 35 PCW. Mature form for sulcal pattern, echogenecity of PVWM, and C-SC
differentiation appears since 34-35 PCW. Conversion to the mature forms was detected in about 98% (191
out of 194 cases) of sulcal pattern after 38 PCW, all cases of echogenecity of PVWM after 40 PCW, and C-SC
differentiation after 41 postconceptional weeks. And sonographic grades for cerebral development were well
correlated with the postconceptional age(r = 0.90, p < 0.0001).
CONCLUSION : Morphologic changes of the sylvian fissure, the sulcal pattern, the echogenecity of PVWM, and the
C-SC differentiation on sonography were identified with increasing postconceptional age. And sonographic
grades were well correlated with the postconceptional age. In conclusion, sonography may be a convenient and
helpful method to evaluate the cerebral developmental changes of the newborn and to predict the postconcep-tional
age. |
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Keyword : Brain, US Brain, growth and development Infants, newborn |
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pdf파일 : 107이영석4.pdf
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