All issues > Volume 36(5); 1993

Original Article

J Korean Pediatr Soc. 1993;36(5):693-704. Published online May 15, 1993.

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

Kyeong Hee KH Cho¹, Myoung Jae MJ Chey¹, Sejung Sj Sohn¹, Kil Hyun KH Kim¹, Hak Soo HS Lee¹, Young Seok YS Lee², Dae Joong DJ 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

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).

Keywords :Periventricular leukomalacia, Risk factors, Outcome