Page 380 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-020
The Use of Lung Ultrasound in Diagnosing Pneumothorax in Preterm Neonates

1
Ireska Tsaniya Afifa , Naela Fadhila , Evita Karianni Bermanshah 2
2
1
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Pneumothorax is a life-threatening condition associated with a high incidence of morbidity and
mortality. It is commonly encountered in neonatal intensive care unit (NICU), especially in ventilated and
preterm neonates. This condition is usually diagnosed using chest X-ray (CXR) and chest transillumination.
Recently, lung ultrasound (LUS) has shown excellent performance in adults to diagnose pneumothorax.
Objective To describe the use of lung ultrasound to diagnose pneumothorax in extremely preterm neonate.
Case An extremely preterm neonate (27 weeks, 750 gram) was diagnosed with respiratory distress syndrome
(RDS) and put on mechanical ventilation. He had a sudden desaturation not responding to positioning and
suctioning. Transillumination of the chest shown positive sign of pneumothorax, confirmed by CXR and
LUS. Conclusion Lung ultrasound is a fast, easy, reliable, reproducible, no radiation exposure method for
early diagnosis and monitoring of pneumothorax.
Keywords: lung ultrasound; pneumothorax; preterm neonate

P-PI-021
The Importance of Head Ultrasound in Early Detection of Periventricular
Hemorrhagic Infarction: A Case Report

1
Rahardi Mokhtar , Naela Fadhila , Evita Karianni Bermanshah 2
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Periventricular Hemorrhagic Infarction (PVHI) is a complication of a germinal matrix
hemorrhage (GMH) in which extension to the periventricular region occurs. The neuropathology of
periventricular hemorrhagic infarction is due to impaired venous drainage of the medullary veins in the
periventricular white matter. PVHI is seen in 15-20% of very preterm infants with intraventricular hemorrhage
(IVH), 50%-85% of children with survival PVHI develop cerebral palsy (CP) and that cognition is impaired in
20%-79% of children. Recently, the use of head ultrasound in neonate has increased due to non-ionic radiation,
bedside, easy, fast, real time, reproducible, and low cost. The indication of head ultrasound in neonate is for
screening brain injury, especially in preterm infant, including PVHI. Objective To describe the sonographic
characteristics of PVHI. Case Extremely preterm girl, 27 weeks, 1000 gram was born with C-section due
to 5 days premature rupture of membrane. She had respiratory distress syndrome and was intubate, and got
mechanical ventilation support. During hospitalization in NICU she had neonatal pneumonia and multiple
ileal perforation due to necrotizing enterocolitis (NEC). On the 3rd day the baby had focal seizure, and head
ultrasound found left IVH grade 1. On the 28th day, patient re-performed head ultrasound and found left
PVHI. Conclusion PVHI can be found by head ultrasound. Serial head ultrasound should be perfomed in
baby with IVH to detect PVHI. Infant with PVHI has high risk to develop neurodevelopmental disorders.
Keywords: PVHI; preterm; head ultrasound

332 KONIKA XVIII Abstract Book