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Updated: Oct 9, 2025
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Neuroradiological Mimics of Periventricular Leukomalacia
Nihaal Reddy1, Mary Doyle2, Prasad Hanagandi3
1Rainbow Children's Hospital and Tenet Diagnostics, Hyderabad, India.
Aim:
Periventricular leukomalacia (PVL) is a term reserved to describe white matter injury in the premature brain. In this review article, the authors highlight the common and rare pathologies mimicking the chronic stage of PVL and propose practical clinico-radiological criteria that would aid in diagnosis and management.
Methods And Results:
The authors first describe the typical brain MRI (magnetic resonance imaging) features of PVL. Based on their clinical presentation, pathologic entities and their neuroimaging findings were clustered into distinct categories. Three clinical subgroups were identified: healthy children, children with stable/nonprogressive neurological disorder, and those with progressive neurological disorder. The neuroradiological discriminators are described in each subgroup with relevant differential diagnoses. The mimics were broadly classified into normal variants, acquired, and inherited disorders.
Conclusions:
The term "PVL" should be used appropriately as it reflects its pathomechanism. The phrase "white matter injury of prematurity" or "brain injury of prematurity" is more specific. Discrepancies in imaging and clinical presentation must be tread with caution and warrant further investigations to exclude other possibilities.
Insights
Periventricular leukomalacia (PVL) mimics can be identified using clinico-radiological criteria. Distinguishing these from true PVL ensures accurate diagnosis and management of white matter injury in premature infants.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Periventricular leukomalacia (PVL) describes white matter injury in premature infants.
- Accurate diagnosis is crucial for appropriate management and understanding prognosis.
Purpose of the Study:
- To review common and rare pathologies mimicking chronic-stage PVL.
- To propose clinico-radiological criteria for differentiating these mimics.
- To refine the appropriate use of the term PVL.
Main Methods:
- Review of brain MRI features of PVL.
- Clustering of pathologic entities and neuroimaging findings based on clinical presentation.
- Classification of mimics into normal variants, acquired, and inherited disorders.
- Identification of three clinical subgroups: healthy, stable neurological disorder, and progressive neurological disorder.
Main Results:
- Detailed description of typical PVL MRI features.
- Neuroradiological discriminators and differential diagnoses presented for each clinical subgroup.
- Mimics categorized to aid in differential diagnosis.
Conclusions:
- The term "PVL" should be used precisely, with "white matter injury of prematurity" or "brain injury of prematurity" being more specific.
- Discrepancies between imaging and clinical findings necessitate caution and further investigation.
- Accurate differentiation of PVL mimics is essential for patient care.
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