Comparing the Diagnosis of White Matter Injury in Premature Newborns with Serial MR Imaging and Transfontanel Ultrasonography Findings
Steven P. Millera,
Camilla Ceppi Cozzioa,
Ruth B. Goldsteinc,
Donna M. Ferrieroa,b,
J. Colin Partridgeb,
Daniel B. Vigneronc and
A. James Barkovicha,c
a Department of Neurology, University of California San Francisco, San Francisco, CA
b Department of Pediatrics, University of California San Francisco, San Francisco, CA
c Department of Radiology, University of California San Francisco, San Francisco, CA
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FIG 1. Minimal white matter injury shown on ultrasonograms and MR images of premature neonate born 31.1 weeks after conception and studied at 32.9 weeks postconceptional age.
A, Coronal view transfontanel ultrasonograms show diffuse foci of mildly increased echogenicity (less than that of the choroid plexus) in addition to irregularity of the lateral borders of the periventricular white matter (arrowheads).
B, Corresponding MR images (spoiled gradient-echo volumetric images) show a few small foci of T1 hyperintensity in the absence of marked T2 hypointensity, which were thought to represent astrogliosis in the periventricular white matter without cavitation (arrow). The abnormalities shown by MR imaging and ultrasonography are not anatomically concordant, although both were graded as minimal white matter abnormalities.
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FIG 2. Images show moderate to severe white matter injury in a premature neonate born 29.1 weeks after conception and studied at 32 weeks postconceptional age
A, Coronal view transfontanel ultrasonogram shows small areas of hypoechogenicity in the periventricular white matter, indicating small areas of cavitation, in addition to pronounced ventriculomegaly (arrowhead).
B and C, Corresponding MR images (spoiled gradient-echo volumetric images) show small areas of T1 hypointensity, indicating cavitation in the periventricular white matter (B, arrow), in addition to multiple small foci of T1 hyperintensity in the absence of marked T2 hypointensity, which were thought to represent astrogliosis in the periventricular white matter (C, arrow). The degree of ventriculomegaly is similar on the ultrasonogram and MR images. Note that the areas of T1 hyperintensity are more extensive than the small cystic lesions evident on the ultrasonogram or MR images.
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