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Related Experiment Videos

[Sequential MRI in two cases with periventricular leukomalacia].

N Fujimoto1, K Sugita, H Niimi

  • 1Department of Pediatrics, Chiba University School of Medicine.

No to Hattatsu = Brain and Development
|July 1, 1991
PubMed
Summary

Magnetic resonance imaging (MRI) effectively detected subtle cystic periventricular leukomalacia lesions in infants, complementing ultrasonography (US) findings and revealing delayed myelination and white matter abnormalities.

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Area of Science:

  • Neuroimaging
  • Pediatric Neurology
  • Neuroradiology

Background:

  • Cystic periventricular leukomalacia (cPVL) is a significant cause of neurological impairment in premature infants.
  • Early detection of cPVL is crucial for timely intervention and management.
  • Ultrasonography (US) is commonly used for neonatal brain imaging, but may miss subtle lesions.

Observation:

  • Two infants with cPVL, initially detected by US, underwent serial brain MRI at corrected ages of 4, 9, and 15-19 months.
  • MRI utilized inversion-recovery (IR) and T2-weighted spin-echo (SE) sequences.
  • Cysts were observed in the periventricular white matter adjacent to the frontal horns (Case 1) and posterior horns (Case 2).

Findings:

  • Early MRI (4 months) showed ventricular wall irregularity and delayed myelination compared to controls.

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  • Subsequent MRIs (9 and 15-19 months) revealed progressively evident T2-weighted hyperintensities in the white matter.
  • End-stage cPVL lesion locations on MRI correlated with US-identified cystic areas.
  • Sagittal MRI views were particularly useful for identifying main cPVL lesions.

    • Implications:

    • Serial MRI provides detailed characterization of cPVL progression and lesion evolution.
    • MRI demonstrates superior sensitivity for detecting subtle cPVL lesions not visible on US.
    • Advanced MRI techniques may enhance the early diagnosis and monitoring of cPVL, potentially improving neurodevelopmental outcomes.