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Correlation between magnetic resonance imaging and clinical profiles of periventricular leukomalacia
S Fujimoto1, H Togari, T Banno
1Department of Pediatrics, Nagoya City University Medical School, Nagoya, Japan. sfujimot@med.nagoya-cu.ac.jp
Insights
Periventricular leukomalacia (PVL) in children shows MRI findings correlating with neurological outcomes. Reduced white matter on MRI is the most reliable predictor of cerebral palsy and cognitive impairment in PVL patients.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Periventricular leukomalacia (PVL) is a common cause of neurological disability in preterm infants.
- Early identification of prognostic indicators is crucial for managing cerebral palsy (CP) and cognitive impairments.
Purpose of the Study:
- To investigate correlations between MRI findings and clinical outcomes in children with PVL.
- To identify the most reliable MRI parameter for predicting neurological prognosis in PVL.
Main Methods:
- Analysis of MRI findings in 70 children diagnosed with PVL.
- Correlation of MRI parameters (ventriculomegaly, white matter reduction, T2 hyperintensity) with neurological assessments (CP severity, mental impairment).
- Evaluation of MRI findings in relation to gestational age.
Main Results:
- Ventriculomegaly grade correlated with CP severity but not mental impairment.
- Reduced periventricular white matter showed strong correlation with both CP severity and mental impairment, serving as a reliable prognostic indicator.
- Periventricular T2 hyperintensity correlated with mental impairment and was lower in infants born before 28 weeks gestation.
Conclusions:
- Reduced periventricular white matter on MRI is the most reliable predictor of neurological deficits in children with PVL.
- Gestational age should be considered when interpreting periventricular T2 hyperintensity in PVL.
- MRI offers valuable insights into the neurological prognosis of PVL.
Abstract:
Magnetic resonance imaging (MRI) findings of 70 children with periventricular leukomalacia (PVL), examined between 1 year 2 months and 8 years of age (mean: 2 years 4 months of age), were analysed. Neurological assessments were made between 1 year 3 months and 15 years (mean: 4 years 9 months). The possible correlations between MRI findings and clinical profiles of PVL were investigated using three parameters of the MRI findings. The grade of ventriculomegaly correlated well with the severity of cerebral palsy (CP) but not with the severity of mental impairment. The grade of reduction of periventricular white matter correlated well with the severity of CP and mental impairment, and is the most reliable parameter for neurological prognosis. The degree of periventricular hyperintensity on T2-weighted images did not correlate well with severity of CP, but correlated to some degree with mental impairment. There was a significantly lower degree of periventricular hyperintensity in children at less than 28 weeks of gestation than at 28 or more weeks of gestation, but no significant difference in other parameters. The periventricular hyperintensity should be evaluated in view of the gestational age.