YU.P. VASILYEVA, N.V. SKRIPCHENKO, A.V. KLIMKIN, A.A. VILNITS, N.V. MARCHENKO, B.V. OSTAPENKO

Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg

 Contact details:

Vasilieva Yu.P. — PhD (medicine), Senior Researcher of the Department of Functional and Radiology Diagnostics

Address: 9 Professor Popov St., Russian Federation, Saint Petersburg, 197022, tel.: +7-911-923-45-05, e-mail: vasiliev.yar@gmail.com

 The article presents the results of analysis of 3466 examinations (2012–2018), obtained from screening of brain (neurosonography) and spinal cord (spinal ultrasonography) in children during an outpatient prophylactic examination (n = 593) and in the infectious hospital as a primary structural diagnostics of patients with a suspected infectious disease (n = 2873). In prophylactic screening, over a half of children (67%) demonstrated pathological changes in brain, of which 4,1% patients had symptomless course of structural deficit, which may cause unfavorable consequences. Spinal ultrasonography during an outpatient screening showed ultrasound symptoms of the spinal cord in 61% cases. When an infectious disease was suspected in the infectious hospital, neurosonography showed pathological changes in brain in 45% patients, and in 90% of cases the revealed disorders were not of infectious nature, but served as the ground for changing the therapeutic tactics, which determined the outcome of the main disease. The presented clinical cases substantiate the need for ultrasound screening of not only the brain but also the spinal cord at dispensarization of young children. The obtained results show the need to perform planned neurosonography at birth, at 1 and 3 months, at 1 year, further on indications stemming from previous examinations. Spinal ultrasonography should be performed to all children at the age of 1 month. The article also presents the experience of sonography screening in children with infectious diseases, which confirms the need to perform neurosonography during primary diagnostics in children of all ages with infectious diseases accompanied by general cerebral syndrome.

Keywords: ultrasound, neurosonography, spinal ultrasonography, children, screening, monitoring.

REFERENCES

1. Iova A.S., Garmashov Yu.A., Andrushchenko N.V. Ul’trasonografiya v neyropediatrii (novye vozmozhnosti i perspektivy): ul’trasonograficheskiy atlas [Ultrasonography in Neuropediatrics (New Opportunities and Prospects). Ultrasonographic Atlas]. Saint Petersb.urg: Izd-vo Petrovskay i K’, 1997. 160 p.
2. Vatolin K.V., Bykova Yu.K., Pykov M.I., Milovanova O.A. Detskaya ul’trazvukovaya diagnostika: uchebnik. Nevrologiya. Sosudy golovy i shei [Pediatric ultrasound diagnostics: textbook. Neurology. Vessels of the head and neck]. 368 p.
3. Zubareva E.A., Zubarev A.R., Patrusheva E.N. Neurosonography: results and development prospects. Ul’trazvukovaya diagnostika, 2000, no. 2, p. 99 (in Russ.).
4. Ol’khova E.B., Dubasova N.M. The advantages of polypositional neurosonography in the diagnosis of meningeal hemorrhages in young children. Radiologiya. Praktika, 2015, no. 5 (53), pp. 22–35 (in Russ.).
5. Marchenko I.A. Kompleksnaya spinal’naya neyrosonografiya (metodika i klinicheskoe znachenie): avtoref. dis…. kand. med. nauk [Complex spinal neurosonography (technique and clinical significance). Synopsis of dis. PhD med. sciences]. Saint Petersburg, 2006.
6. Kuznetsova L.V. Vozmozhnosti spinal’noy ul’trasonografii v diagnostike zabolevaniy pozvonochnika i spinnogo mozga u detey: nauchnoe elektronnoe izdanie [Possibilities of spinal ultrasonography in the diagnosis of diseases of the spine and spinal cord in children: scientific electronic publication]. Petrozavodsk: Izdatel’stvo PetrGU, 2016. 112 p.
7. Lowe L.H., Johanek A.J., Moore Ch.W. Sonography of the Neonatal Spine: Part 2, Spinal Disorder. AJR, 2007, March, vol. 188 (3), available at: https:www.ajronline.org/doi/full/10.2214/AJR.05.2160
8. Khromova S.V. Sostoyanie tsentral’noy nervnoy sistemy i tserebral’naya gemodinamika u donoshennykh detey pervykh dvukh let zhizni, perenesshikh vnutrizheludochkovye krovoizliyaniya: avtoref. dis. … kand. med. nauk [The state of the central nervous system and cerebral hemodynamics in full-term infants in the first two years of life who have undergone intraventricular hemorrhage. Synopsis of dis. PhD med. sciences]. Ivanovo, 2004. 25 p.
9. Bayram E., Bayram M., Topcu Y. et al. Long term neurodevelopmental outcome of preterm infants with periventricular-intraventricular hemorrhage. J of Clinical and Experimental Investig, 2012, vol. 3 (3).
10. Tsai A.J., Lasky R.E., John S.D. Predictors of neurodevelopmental outcomes in preterm infants with intraparenchymal hemorrhage. J. Perinatol, 2014, Feb, vol. 20.
11. Makhoul I.R., Eisenstein I., Sujov P., Soudack M., Smolkin T., Tamir A., Epelman M. Neonatal lenticulostriate vasculopathy: further characterization. Arch Dis Child Fetal Neonatal, 2003, vol. 88, pp. F410–F414.
12. Qu Z, et al. Zhonghua Yi Xue Za Zhi. Analysis of misdiagnosis causes of suprasellar arachnoid cysts. 2020, available at: https://www.ncbi.nlm.nih.gov/m/pubmed…/32164116/?i=4&from=arachnoid%20cysts%20children%20ultrasound#fft
13. Protokoly neonatal’noy meditsinskoy pomoshchi na etape rodil’nogo doma: uchebnoe posobie, pod red. F.P. Romanyuka, A.S. Iova [Protocols of neonatal medical care at the stage of the maternity hospital: textbook. Ed. by F.P. Romanyuk, A.S. Job]. Saint Petersburg: Asterion, 2018. 88 p.
14. Zlotnikova T.V. Algoritmy kliniko-neyrosonograficheskoy diagnostiki i lechenie bakterial’nykh gnoynykh meningitov u detey: avtoref. dis.… kand. med. nauk [Algorithms for clinical and neurosonographic diagnostics and treatment of bacterial purulent meningitis in children. Synopsis of dis. PhD med. sciences]. Saint Petersburg, 2002.
15. Volpe J.J. Bacterial and fungal intracranial infections. Neurology of the newborn. Philadelphia, 2001. Pp. 774–810.
16. Yikilmaz A., Taylor G. Sonographic findings in bacterial meningitis in neonates and young infants. Pediatric Radiology, 2008, vol. 38, pp. 129–37.
17. Vasil’eva Yu.P., Komantsev V.N., Skripchenko N.V. UZI-diagnostika bakterial’nykh gnoynykh meningitov [Ultrasound diagnostics of bacterial purulent meningitis]. Neyroinfektsii u detey. Saint Petersburg: «Taktik-Studio», 2015. Pp. 282-297.
18. Vil’nits A.A., Skripchenko N.V., Vasil’eva Yu.P. Kliniko-ul’trazvukovaya diagnostika intrakranial’nykh oslozhneniy pri bakterial’nykh gnoynykh meningitakh u detey rannego vozrasta [Clinical and ultrasound diagnostics of intracranial complications in bacterial purulent meningitis in young children]. II Mezhdunarodnyy forum «Puti snizheniya detskoy smertnosti ot infektsionnykh i parazitarnykh zabolevaniy: Rossiyskiy opyt» (materialy). Saint Petersburg: Izd-vo «Chelovek i ego zdorov’e», 2012. Pp. 5-22.
19. Vasil’eva Yu.P., Ostapenko B.V., Skripchenko N.V. Ul’trazvukovaya diagnostika gnoynykh meningitov i oslozhneniy u detey [Ultrasound diagnosis of purulent meningitis and complications in children]. Gnoynye meningity u detey: rukovodstvo dlya vrachey. Saint Petersburg: SINEL, 2017. P. 254.
20. Vasil’eva Yu.P., Ckripchenko N.V., Vil’nits A.A. Ultrasound examination in the diagnosis and monitoring of lesions of the meninges of the brain in neuroinfections in children (meningitis, meningoencephalitis). NPZh «Meditsina ekstremal’nykh situatsiy», 2017, no. 1 (59), pp. 39–46 (in Russ.).
21. Skripchenko N.V. Lobzin Yu.V., Voytenkov V.B., Karev V.E., Alekseeva L.A., Vasil’eva Yu.P., Klimkin A.V. Innovations in the management of neuroinfections in children. NPZh «Detskie infektsii», 2017, no. 3, pp. 5–9 (in Russ.).
22. Vasil’eva Yu.P. Ul’trazvukovaya diagnostika golovnogo mozga i serdtsa. Meningokokkovaya infektsiya u detey: rukovodstvo dlya vrachey [Ultrasound diagnostics of the brain and heart. Meningococcal infection in children: a guide for doctors]. Saint Petersburg: Taktik-Studio, 2015. Pp. 114–121.
23. Nikiforov B.M., Matsko D.E. Opukholi golovnogo mozga: kratkoe rukovodstvo [Brain tumors: a quick guide]. Saint Petersburg: Izdatel’skiy Dom PITER, 2003. 313 p. ISBN: 978-5-94723-250-9.
24. Rubin A.N., Shcherbuk Yu.A., Lyapin A.P. Diagnostics and differential treatment of brain abscesses in children. Vestnik SPbGU, 2014, no. 11, iss. 4, pp. 153–161 (in Russ.).
25. Iova A.S., Kryukova I.A., Iova D.A. Pansonoskopiya pri politravme (modernizatsiya «ul’trasonografii vsego tela» i FAST-protokola): uchebnoe posobie [Pansonoscopy for polytrauma (modernization of «whole body ultrasonography» and FAST-protocol): a tutorial]. Saint Petersburg, 2013. 56 p.
26. Vil’nits A.A. Gnoynye meningity u detey: kliniko-patgeneticheskie, diagnosticheskie, prognosticheskie i terapvtichekie aspekty inrakranial’nykh oslozhneniy: avtoref. dis. … dokt. med. nauk [Purulent meningitis in children: clinical and pathogenetic, diagnostic, prognostic and therapeutic aspects of intracranial complications. Synopsis of dis. Dr med. sciences]. Saint Petersburg, 2019. 43 p.
27. Vasil’eva Yu.P., Nurok M.Yu., Cherkashina I.V., Stanislavskaya O.V., Savina M.V. Ultrasound diagnosis of anomalies in the development of the cervical spine (clinical case). NPZh «Neyrokhirurgiya i nevrologiya detskogo vozrasta», 2018, no. 3 (57), pp. 60–67 (in Russ.).
28. Nikul’shina L.G. Luchevaya diagnostika natal’nykh spinal’nykh travm: avtoref. diss. …kand. med. nauk [Radiation diagnostics of natal spinal injuries. Synopsis of dis. PhD med. sciences]. Kursk, 2017. 20 p.