Korean Journal of Pediatrics 2009;52(10):1127-1135.
Published online October 15, 2009.
Magnetic resonance imagining findings of the white matter abnormalities in the brain of very-low-birth-weight infants
Jae Hyuk Choi, Young Pyo Chang
Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
극소 저체중 출생아에서 뇌백질 병변의 MRI 소견
최재혁, 장영표
단국대학교 의과대학 소아과학교실
Abstract
Purpose
: To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low- birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL).
Methods
: In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined.
Results
: MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15–2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82–0.99 P=0.036) for noncystic PVL were only significant independently.
Conclusion
: White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.
Key Words: Leukomalacia, Periventricular, Magnetic resonance imaging, Infant, Very low birth weight


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