Feasibility of cerebellar measurements with phased-array sonography through the anterior fontanelle in comparison to MRI

OBJECTIVE: Cerebral sonography through the anterior fontanelle is a neonatal brain imaging method that has become an integral part of modern neonatal bedside care for both screening and diagnostic purposes. Premature infants with cognitive delay have a reduction in cerebellar size at term corrected age on MRI. We aimed to determine the level of agreement between postnatal MRI and cerebral sonography for cerebellar biometry and to determine the level of agreement within one and between different examiners.  STUDY DESIGN: Cerebellar sonography and MRI measurements of the cerebellum from 30 term infants was assessed by Bland-Altman plots. Measurements between both modalities were compared using Wilcoxon Signed-Rank Test. A p-value RESULTS: There was no statistically significant difference between cerebral sonography and MRI for linear measurements, but the measurements of perimeter and surface area differed significantly between the two techniques. There was a systematic bias between both modalities for most measurements except for anterior-posterior width and vermis height. For measurements that were not statistically different from MRI we found excellent intra-rater ICC for the anterior-posterior width, vermis height and cerebellar width. The inter-rater ICC was excellent for the anterior-posterior width and vermis height, but poor for the transverse cerebellar width.  CONCLUSIONS: With a strict imaging protocol cerebellar measurements of the anterior-posterior width and the vermis height can be used as an alternative to MRI for diagnostic-screening purposes in a neonatal department where multiple clinicians perform bedside cerebral sonography.</p