[MS4-2D-4] Comparison of MRI Findings between Neonatal Period and 18 Months of Age in Infants who Developed Periventricular Leukomalacia
[Introduction] MRI findings of periventricular leukomalacia (PVL) show changes over time from the neonatal period to after infancy. There are few reports comparing MRI findings between these periods in patients with PVL. We investigated MRI findings in the neonatal period and the neurological prognosis of the patients whose MRI at 18 months of age showed findings of end-stage PVL.
[Methodology] In total, 20 patients whose gestational ages ranged from 28 to 34 weeks and whose MRIs at age 18 months showed findings of end-stage PVL, such as periventricular gliosis, irregular ventricular walls, and reduced white matter volume, were included. Their MRI findings in the neonatal period and their neurological prognoses were investigated.
[Results] Among the 20 patients, nine had cystic lesions (Cyst group), six had non-cystic signal abnormalities, including corticospinal tracts (CST group), two had punctate signal abnormalities, excluding corticospinal tracts, and three had no abnormal findings in MRIs in the neonatal period. Developmental quotients, measured with the Kyoto Scale of Psychological Development, at age 18 months were 67 (38-92), 81 (55-93), 78.5 (61-96), and 78 (75-79) for the group [medians (range)]. Between the Cyst and CST groups, there were no significant differences.
[Conclusions] Although MRI abnormalities in the neonatal period were subtle, at age 18 months, some cases showed clear findings of PVL and their prognoses were poor. Physicians should be aware that brain injuries may be broader than those that can be detected with MRI during the neonatal period.
[Methodology] In total, 20 patients whose gestational ages ranged from 28 to 34 weeks and whose MRIs at age 18 months showed findings of end-stage PVL, such as periventricular gliosis, irregular ventricular walls, and reduced white matter volume, were included. Their MRI findings in the neonatal period and their neurological prognoses were investigated.
[Results] Among the 20 patients, nine had cystic lesions (Cyst group), six had non-cystic signal abnormalities, including corticospinal tracts (CST group), two had punctate signal abnormalities, excluding corticospinal tracts, and three had no abnormal findings in MRIs in the neonatal period. Developmental quotients, measured with the Kyoto Scale of Psychological Development, at age 18 months were 67 (38-92), 81 (55-93), 78.5 (61-96), and 78 (75-79) for the group [medians (range)]. Between the Cyst and CST groups, there were no significant differences.
[Conclusions] Although MRI abnormalities in the neonatal period were subtle, at age 18 months, some cases showed clear findings of PVL and their prognoses were poor. Physicians should be aware that brain injuries may be broader than those that can be detected with MRI during the neonatal period.