Periventricular infarction diagnosed by ultrasound: a postmortem correlation

Area of Science:

• Neonatal neurology
• Pediatric radiology
• Medical imaging

Background:

• Periventricular white matter abnormalities, including increased echogenicity or cysts, are observed in preterm infants.
• These findings often localize to the superolateral aspect of the ventricle, a common site for periventricular infarction.

Purpose of the Study:

• To evaluate the diagnostic accuracy of sector ultrasound brain scans for periventricular infarction in preterm infants.

Main Methods:

• A study was conducted over 33 months involving 23 preterm infants who died after 20 days of life.
• Autopsies were performed to confirm the presence and extent of periventricular infarction.
• Ultrasound scan findings (echogenicity, cysts) were compared with autopsy results.

Main Results:

• Superolateral echogenicity or cysts were identified in 57% of the infants studied.
• Periventricular infarction was confirmed at autopsy in 52% of cases.
• Ultrasound demonstrated high accuracy (78%) in diagnosing the size, site, and extent of periventricular infarction, though interpretive errors occurred with suboptimal scan quality or timing.

Conclusions:

• Sector ultrasound brain scans are effective in accurately diagnosing major periventricular infarction in preterm infants.
• Hemorrhage within the infarction site is not essential for ultrasound diagnosis.
• The study highlights the utility of ultrasound in neonatal brain imaging for detecting significant periventricular lesions.