الفهرس 
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Abstract
The neonates in ICU are vulnerable to the hazards of extra-uterine life especially preterm neonates with fragile cerebral vasculature. Neonatal care in El-Minia University is advancing at an impressive phase at the level of the community.
Ultrasonography is operator dependent, and the quality of the study is intimately related to the skill and experience of the sonologist as well as their knowledge of the anatomy and pathology of the neonatal brain. Clinical application of this imaging method is extremely useful for neonates, particularly when cUS performed early will contribute with valuable data for a better therapeutic approach and neurological development of pediatric patients.
This study highlights the convenience and diagnostic efficiency of cranial ultrasound in high risk neonates in NICU.
Cranial US examination can be performed through various windows and planes either separately or combined. In this study, the main approach of cUS examination was the anterior fontanel approach in coronal and sagittal planes. Typically, six coronal images were obtained, followed by five standard sagittal and parasagittal images. The posterior fontanel in coronal and sagittal plans and mastoid views were used as additional windows.
This study included 120 neonates presented to neonatal intensive care unit of El Minia University hospital. They were divided into two groups: group I (preterm) included 80 neonates and group II (full term) included 40 neonates.
In this study, cUS findings were detected in (68.3%) of all examined neonates. The most common findings in preterm neonates were hemorrhage detected in (22.5%), PVL in (22.5%) and hydrocephalus in (12.5%) neonates.
In full term neonates, cUS findings were found in (45%). Hydrocephalus detected in (15%), HIE in (15%), followed by intracerebral hemorrhage in (10%) neonates.
The 3 major brain findings that were detected by cUS in preterm neonates (GM-IVH, PVL and hydrocephalus) were further classified into different grades. The GM-IVH (18 cases) was classified into 4 grades, PVL (18 cases) was graded into 5 grades, and hydrocephalus (10 cases) was classified according to its severity into mild, moderate and severe degrees.
The HIE (6 cases) in full term neonates was classified as follow: peripheral type of HIE in 1 (2.5%) neonates, central type in 2 (5 %) neonates and diffuse type in 3 (7.5 %) neonates
The diagnostic accuracy of cUS examination for detecting various brain injuries in high risk neonates were assessed using CT examination as a gold standard reference, accordingly the total accuracy of cUS examination was 86.7% with a sensitivity of 88.1% and specificity of 83.3%.
Color Doppler examinations were performed for all the neonates included in this study for assessing the patency of MCA and ACA with estimation of PSV, EDV and RI indices.
There was a statistically significant difference between the 2 groups of neonates as regarding to all the MCA and ACA indices (PSV, EDV and RI) (p=0.001, p=0.001).