Usefulness of Routine Head Ultrasound Scans Before Surgery for Congenital Heart Disease

Danielle R. Rios; Stephen E. Welty; Julia K. Gunn; John Beca; Charles G. Minard; Michelle Goldsworthy; Lee Coleman; Jill V. Hunter; Dean B. Andropoulos; Lara S. Shekerdemian

doi:10.1542/peds.2012-3734

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Usefulness of Routine Head Ultrasound Scans Before Surgery for Congenital Heart Disease

Journal article

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Peer reviewed

Usefulness of Routine Head Ultrasound Scans Before Surgery for Congenital Heart Disease

Danielle R. Rios, Stephen E. Welty, Julia K. Gunn, John Beca, Charles G. Minard, Michelle Goldsworthy, Lee Coleman, Jill V. Hunter, Dean B. Andropoulos and Lara S. Shekerdemian

Pediatrics (Evanston), Vol.131(6), pp.E1765-E1770

06/01/2013

DOI: 10.1542/peds.2012-3734

PMCID: PMC3666114

PMID: 23690521

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Abstract

OBJECTIVE: The purpose of this study was to assess the utility of preoperative head ultrasound scan (HUS) in a cohort of newborns also undergoing preoperative MRI as part of a prospective research study of brain injury in infants having surgery for congenital heart disease (CHD). METHODS: A total of 167 infants diagnosed with CHD were included in this 3-center study. None of the patients had clinical signs or symptoms of preoperative brain injury, and all patients received both HUS and brain MRI before undergoing surgical intervention. HUS and MRI results were reported by experienced neuroradiologists who were blinded to any specific clinical details of the study participants. The findings of the individual imaging modes were compared to evaluate for the presence of brain injury. RESULTS: Preoperative brain injury was present on HUS in 5 infants (3%) and on MRI in 44 infants (26%) (P < .001). Four of the HUS showed intraventricular hemorrhage not seen on MRI, suggesting false-positive results, and the fifth showed periventricular leukomalacia. The predominant MRI abnormality was white matter injury (n = 32). Other findings included infarct (n = 16) and hemorrhage (n = 5). CONCLUSIONS: Preoperative brain injury on MRI was present in 26% of infants with CHD, but only 3% had any evidence of brain injury on HUS. Among positive HUS, 80% were false-positive results. Our findings suggest that routine HUS is not indicated in asymptomatic term or near-term neonates undergoing surgery for CHD, and MRI may be a preferable tool when the assessment of these infants is warranted.

Pediatrics

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: Usefulness of Routine Head Ultrasound Scans Before Surgery for Congenital Heart Disease
Creators: Danielle R. Rios - Texas Children's Hospital
Stephen E. Welty - aDepartments of Pediatrics, Section of Neonatology,
Julia K. Gunn - Royal Children's Hospital
John Beca - Starship Children's Health
Charles G. Minard - Baylor College of Medicine
Michelle Goldsworthy - Baylor College of Medicine
Lee Coleman - Royal Children's Hospital
Jill V. Hunter - gDiagnostic Imaging, and
Dean B. Andropoulos - Baylor College of Medicine
Lara S. Shekerdemian - Baylor College of Medicine
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.131(6), pp.E1765-E1770
Publisher: Amer Acad Pediatrics
DOI: 10.1542/peds.2012-3734
PMID: 23690521
PMCID: PMC3666114
ISSN: 0031-4005
eISSN: 1098-4275
Number of pages: 6
Grant note: Green Lane Research and Education Fund Brain and Immuno-Imaging Grant Victorian Government's Operational Infrastructure Support Program R21HD055501 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) 0942 / Baylor College of Medicine General Clinical Research Center; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) Charles A. Dana Foundation Heart Foundation of New Zealand Texas Children's Hospital Pediatric Anesthesiology Research Fund 1R21-HD55501-01 / US National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) M01 RR00188 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA M01RR000188 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) Australian and New Zealand Intensive Care Foundation Murdoch Childrens Research Institute National Heart Foundation of Australia Dan L. Duncan Institute for Clinical and Translational Research at Baylor College of Medicine, Houston, Texas
Language: English
Date published: 06/01/2013
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984353832402771

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