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Periventricular Leukomalacia -Ultrasonographic Findings, Risk Factors and Neurological Outcome-

Journal of the Korean Pediatric Society 1993;36(5):693-704.
Published online May 15, 1993.
Periventricular Leukomalacia -Ultrasonographic Findings, Risk Factors and Neurological Outcome-
Kyeong Hee Cho1, Myoung Jae Chey1, Sejung Sohn1, Kil Hyun Kim1, Hak Soo Lee1, Young Seok Lee2, Dae Joong Kim3
1Department of Pediatrics, Gil General Hospital, Incheon, Korea
2Department of Radiology, Gil General Hospital, Incheon, Korea
3Department of Internal Medicine, Gil General Hospital, Incheon, Korea
뇌실주위 백질연화증 -초음파 소견, 위험인자 및 신경학적 예후-
조경희1, 최명재1, 손세정1, 김길현1, 이학수1, 이영석2, 김대중3
1중앙길병원 소아과
2중앙길병원 방사선과
3중앙길병원 내과
Abstract
The thirty eight newborn infants with periventricular leukomalacia who were admitted to the neonatal intensive care unit of Gil General Hospital from March 1, 1988 to June 30, 1991, were investigated for ultrasonographic findings, risk factors and neurological outcome. The results were as follows: 1) There were 38 cases of PVL including 21 echogenic flarings and 17 cystic PVL뭩. 2) Mean birth weight was 2,250 gm and mean gestational age was 35 week. 3) Mean detection timing was 4th day in echogenic flarings and 18th day in cystic PVL's. 4) PVL's were located in the parietal region in 1 case and fronto-parieto-occipital in 3 cases. 5) Mean cyst size was 6mm. 6) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, apnea and seizure were the most significant contributing factors (p<0.05). 7) In the follow-up study of cystic PVL's, 7 cases showed improvement, 7 cases developted into multicystic encephalomalacia and 3 cases developed into atrophy. 8) Neurodevelopmental outcome of cystic PVL's showed nomal; 6.2%, minor neurodevelopmental defect; 43.8%, major neurodevelopmental defect; 31.2% and death; 18.8%. 9) Neurosonographic predictability for neurodevelopemetal sequelae by cystic PVL's showed sensitivity; 63.6%, specificity; 98.0%, positive predictive value; 92.8% and accuracy; 88.2%. 10) Major neurodevelopmental defect was more frequent, cyst size beig larger and location being more extensive (p<0.05).
Key Words: Periventricular leukomalacia, Risk factors, Outcome


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