PEDIATRICS Vol. 42 No. 1 July 1968, pp. 157-174
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TWO-DIMENSIONAL ULTRASONOGRAPHY: A METHOD TO STUDY NORMAL AND ABNORMAL VENTRICLES

Cesare T. Lombroso M.D.1, Giuseppe Erba M.D.1, Takeo Yogo M.D.1, and Nancy Logowitz 1

1 Seizure Unit, Department of Neurology, the Children's Hospital Medical Center, and the Departments of Neurology and Pediatrics, Harvard Medical School, Boston

The authors describe an atraumatic diagnostic test apt to reveal the presence of hydrocephalus and other intracerebral anomalies in the child. It utilizes a multilevel, two-dimensional (B-mode) ultrasonic technique that is painless, safe, and easily repeatable. The use of ultrasound in neurological investigation is reviewed briefly and the advantages and disadvantages of A-mode (unidimensional) versus B-mode scanning (two-dimensional) are considered. Standards for the technique of multilevel B-mode scanning are proposed. Their validity was tested by visual and statistical correlation between ventricular measurements obtained by this technique and those obtained by classic radiological investigation. High values of the correlation coefficient were found. The results collected in scanning a group of approximately 600 infants and children are described for each of the following ventricular portions: the third ventricle, the anterior horns and the bodies of the lateral ventricles, and the trigone-temporal horn complex. Other indices of significance were those relating to the midline structures, whose shifts can be accurately predicted, and the Brain Mantle Index, which can give a rough estimate of regional or diffuse atrophic processes. While certain landmarks (such as those pertaining to the midline, third and lateral ventricles) are frequently obtained and measurable, others like those pertaining to the trigone and temporal horns are much less easily detected. Illustrative scans in normal and abnormal subjects are presented. It was concluded that this technique, although unable to outline the contour of the ventricles, lends itself to a general anatomical survey of the ventricular system both for normative purposes as well as detection of important anomalies.

Submitted on September 8, 1967
Accepted on January 22, 1968