AIM: To evaluate whether transfontanel ultrasonography could serve as a practical and less complex alternative to brain magnetic resonance imaging in infants with hydrocephalus.

MATERIAL and METHODS: In this prospective study, 54 infants diagnosed with hydrocephalus underwent both transfontanel ultrasonography and brain magnetic resonance imaging. A neonatologist and a radiologist independently assessed ventricular measurements, including the Evans index, frontooccipital horn ratio, bilateral ventricular index, anterior horn width, thalamooccipital distance, callosal angle, and corpus callosum length.

RESULTS: Among the 54 infants, 48 (88.9%) received a ventriculoperitoneal shunt. A strong correlation was found between transfontanel ultrasonography and magnetic resonance imaging for most ventricular measurements: Evans index (r=0.875, p=0.0001), frontooccipital horn ratio (r=0.867, p=0.0001), callosal angle (r=0.868, p=0.0001), bilateral ventricular index (left r=0.937, right r=0.944; p=0.0001 for both), bilateral anterior horn width (left r=0.918, right r=0.908; p=0.0001 for both), and bilateral thalamooccipital distance (left r=0.956, right r=0.919; p=0.0001 for both). The correlation for corpus callosum length was statistically significant but weaker (r=0.386, p=0.004).

CONCLUSION: Our study emphasizes that transfontanel ultrasonography?which achieves better results in experienced hands? should be widespread and an excellent alternative to unnecessary and repeated imaging methods.