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Peritrigonal echogenic "blush" on cranial sonography: pathologic correlates.

M A DiPietro, B A Brody, R L Teele

    AJR. American Journal of Roentgenology
    |May 1, 1986
    PubMed
    Summary
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    Neonatal cranial sonography reveals a normal hyperechoic blush near the ventricles. Abnormal echogenicity in this area indicates periventricular leukomalacia, distinguishing between hemorrhagic and non-hemorrhagic forms.

    Area of Science:

    • Neonatal neuroimaging
    • Pediatric neurology
    • Diagnostic ultrasound

    Background:

    • Cranial sonography in neonates commonly shows a hyperechoic blush posterior to the ventricular trigones on parasagittal views.
    • This normal finding is attributed to the parallel fiber interfaces perpendicular to the ultrasound beam via the anterior fontanelle.

    Purpose of the Study:

    • To correlate sonographic findings with pathological diagnoses in neonates.
    • To differentiate normal peritrigonal echogenicity from abnormal findings indicative of specific neonatal brain injuries.

    Main Methods:

    • Sonographic-pathologic correlation was performed in 28 neonatal autopsy cases.
    • Analysis focused on the echogenicity and characteristics of the peritrigonal region on cranial sonograms.

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    Main Results:

    • Normal peritrigonal hyperechogenicity was observed in cases without specific brain pathology.
    • Abnormal, dense, globular, coarse peritrigonal echogenicity correlated with periventricular leukomalacia with hemorrhage.
    • Non-hemorrhagic periventricular leukomalacia and perinatal telencephalic leukoencephalopathy showed normal peritrigonal echogenicity.

    Conclusions:

    • The characteristic hyperechoic blush in neonatal cranial sonography is a normal finding.
    • Abnormal peritrigonal echogenicity is a significant indicator of periventricular leukomalacia with hemorrhage.
    • Sonographic differentiation between hemorrhagic and non-hemorrhagic periventricular leukomalacia is possible based on peritrigonal echogenicity.