Related Experiment Videos
Periventricular leukomalacia: evaluation with MR imaging
Insights
Magnetic resonance (MR) imaging revealed abnormalities in all infants with periventricular leukomalacia. Specific MR findings, including white matter lesions and delayed myelination, correlated with poor patient outcomes.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Neuroradiology
Background:
- Periventricular leukomalacia (PVL) is a common cause of neurological impairment in preterm infants.
- Ultrasound is typically used for initial diagnosis, but its limitations in visualizing white matter abnormalities exist.
Purpose of the Study:
- To evaluate the utility of magnetic resonance (MR) imaging in characterizing periventricular leukomalacia (PVL) in infants.
- To correlate MR findings with neurodevelopmental outcomes.
- To assess the role of MR imaging in monitoring disease progression.
Main Methods:
- Retrospective review of 24 MR images from 12 infants diagnosed with PVL via ultrasound.
- Categorization of MR findings: white matter lesions, ventriculomegaly/atrophy, and myelination status.
- Comparison of follow-up MR examinations for six patients.
Main Results:
- All 12 infants showed abnormalities on MR imaging.
- Key findings associated with poor outcomes included extensive white matter lesions, delayed myelination, lack of myelination progression, and significant cortical atrophy.
- MR imaging effectively depicted myelination extent and progression.
Conclusions:
- MR imaging is a valuable tool for detailed assessment of PVL, offering more comprehensive information than ultrasound.
- Specific MR imaging findings can predict neurodevelopmental outcomes in infants with PVL.
- MR imaging facilitates long-term follow-up of PVL patients, even after fontanel closure.
Abstract:
We reviewed 24 magnetic resonance (MR) images of 12 infants diagnosed as having periventricular leukomalacia based on ultrasound results. Abnormalities were identified on the MR images of every patient and were divided into three categories: distribution of low-signal-intensity areas within the cerebral white matter, degree of ventriculomegaly and brain atrophy, and extent of myelination. Follow-up examinations on six patients were also compared for significant changes. Abnormalities noted on MR images that most consistently related to poor outcome for the patient were low-signal-intensity lesions involving all four cerebral lobes, moderate to severe delays in myelination, lack of progression of myelination, and moderate to severe cortical atrophy. MR imaging was able to depict the extent and progression of myelination, and it may be used to continue follow-up of these patients beyond the time of fontanel closure.