Kim Annink

75 Cerebral ultrasound scoring system for neonates with HIE Figure 1: Example images. a. moderate cerebral edema (1 point), b. severe cerebral edema (2 points), c. moderate periventricular white matter (1 point), d. severe periventricular white matter (2 points), e. moderate subcortical white matter (1 point), f. severe subcortical white matter (2 points), g. moderate thalamus (1 point), h. severe thalamus (2 points), i. moderate putamen (1 point), j. severe putamen (2 points), k. “four column sign” which means that both left and right thalamus and putamen are visible at the coronal view as four columns (1 point), l. visibility of the PLIC (1 point). For the scoring sheet and definitions see Table 1. Table 1: Scoring system. White matter involvement is the sum of edema, periventricular and subcortical whitematter damage (0-6 points). Greymatter involvement includes hyperechogenicity of the thalami, putamen, visibility of the PLIC, and four column sign (0-6 points). Normal-mildly abnormal (0) Moderately abnormal (1) Severely abnormal (2) Total points Impaired white/ grey matter differentiation and/or slit like ventricles Normal differentiation between grey and white matter and open ventricles. Reduced differentiation between grey and white matter and/or slit like ventricles. No differentiation between grey and white matter and slit like ventricles. Hyperechogenicity periventricular white matter Normal echogenicity or minor hyperechogenicity. Moderate or focal hyperechogenicity, not as white as choroid plexus. Severe and diffuse hyperechogenicity, as white as choroid plexus. 4