Role of Trans-Cranial Ultrasound in Correlation with MRI in Diagnosis of Neonatal Encephalopathy

Background: Neonatal encephalopathy poses significant morbidity and mortality risks in newborns, necessitating early and accurate diagnoses to enhance outcomes. While trans-cranial ultrasound (TCUS) has gained attention as a non-invasive imaging technique, its efficacy compared to magnetic resonance imaging (MRI) for diagnosing neonatal encephalopathy is still uncertain. Objective: This study aimed to assess the correlation between TCUS and MRI as diagnostic tools for neonatal brain encephalopathy in both term and preterm infants, focusing on their ability to identify various types of brain injuries. Patients and Methods: Fifty neonates diagnosed with encephalopathy participated in this prospective study. Each infant underwent TCUS and MRI within 48 hours of clinical evaluation. Imaging results were analyzed in relation to clinical outcomes and categorized based on established criteria for neonatal brain injury. TCUS's sensitivity and specificity were calculated against MRI results, which acted as the gold standard. Results: TCUS showed higher sensitivity than MRI for detecting lesions in key areas, such as the thalamus (81.8%), basal ganglia (80%), and periventricular white matter (92.1%). However, its sensitivity was lower for lesions in the corpus callosum (75%) and cerebellar white matter (33.3%). TCUS maintained high specificity (100%) for most lesions, particularly for periventricular and subcortical white matter. Both imaging techniques accurately identified all cases of germinal matrix hemorrhage. Conclusion: TCUS serves as an effective first-line imaging tool for diagnosing neonatal encephalopathy, offering prompt results with high sensitivity and specificity. Nonetheless, MRI remains essential for comprehensive assessments, especially in complex cases, advocating for the combined use of TCUS and MRI in clinical practice to improve neonatal management