Sonographic ventriculography: a new potential use for sonographic contrast agents in neonatal hydrocephalus.

ABSTRACT

BACKGROUND AND PURPOSE: Sonographic identification of communicating and noncommunicating forms of posthemorrhagic hydrocephalus can be difficult. This study evaluates the feasibility of using sonographic contrast agents to determine ventricular patency in a newborn animal model. METHODS: A craniotomy was performed and a catheter was placed under sonographic guidance into the lateral ventricle in five anesthetized newborn piglets. Sonograms were obtained before and after intraventricular injection of 0.01 mL of a sonographic contrast agent (Imagent, formulation AF0150; Alliance Pharmaceutical Corp, San Diego, CA) diluted in 1 mL normal saline, and images were assessed for presence and location of echogenic contrast material. RESULTS: Flow of contrast material was identifiable from the ipsilateral lateral ventricle into the contralateral lateral ventricle, and through the third and fourth ventricles into the basal cisterns during real-time sonography in every animal. Ventricular and cistern echogenicity remained increased for approximately 4 minutes after injection. CONCLUSION: Contrast-enhanced sonographic ventriculography has the potential to identify patency of CSF pathways in newborns with hydrocephalus and an indwelling ventricular catheter.