White matter (WM) injury of prematurity, perinatal WM damage, punctate WM lesions, periventricular leukomalacia (PVL)
Definitions
Perinatal WM injury occurring before 34-weeks gestation
Affected WM is not always periventricular/deep
IMAGING
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Guillot M et al: Comparative performance of head ultrasound and MRI in detecting preterm brain injury and predicting outcomes: a systematic review. Acta Paediatr. 110(5):1425-32, 2021
Jansen L et al: Associations between neonatal magnetic resonance imaging and short- and long-term neurodevelopmental outcomes in a longitudinal cohort of very preterm children. J Pediatr. 234:46-53.e2, 2021
Neil JJ et al: Diffusion magnetic resonance imaging of infants. Magn Reson Imaging Clin N Am. 29(2):185-93, 2021
Agut T et al: Preterm white matter injury: ultrasound diagnosis and classification. Pediatr Res. 87(Suppl 1):37-49, 2020
Benninger KL et al: MR imaging scoring system for white matter injury after deep medullary vein thrombosis and infarction in neonates. AJNR Am J Neuroradiol. 40(2):347-52, 2019
Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
Kendall GS et al: White matter NAA/Cho and Cho/Cr ratios at MR spectroscopy are predictive of motor outcome in preterm infants. Radiology. 271(1):230-8, 2014
Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
de Bruïne FT et al: Clinical implications of MR imaging findings in the white matter in very preterm infants: a 2-year follow-up study. Radiology. 261(3):899-906, 2011
van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
van Wezel-Meijler G et al: Ultrasound detection of white matter injury in very preterm neonates: practical implications. Dev Med Child Neurol. 53 Suppl 4:29-34, 2011
Volpe JJ et al: The developing oligodendrocyte: key cellular target in brain injury in the premature infant. Int J Dev Neurosci. 29(4):423-40, 2011
Kato A et al: Relationship between enlargement of the lateral ventricle and periventricular leukomalacia in infants. J Obstet Gynaecol Res. 36(5):984-90, 2010
Leijser LM et al: Is sequential cranial ultrasound reliable for detection of white matter injury in very preterm infants? Neuroradiology. 52(5):397-406, 2010
Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
Ment LR et al: Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 58(12):1726-38, 2002
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
TERMINOLOGY
Synonyms
White matter (WM) injury of prematurity, perinatal WM damage, punctate WM lesions, periventricular leukomalacia (PVL)
Definitions
Perinatal WM injury occurring before 34-weeks gestation
Affected WM is not always periventricular/deep
IMAGING
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Guillot M et al: Comparative performance of head ultrasound and MRI in detecting preterm brain injury and predicting outcomes: a systematic review. Acta Paediatr. 110(5):1425-32, 2021
Jansen L et al: Associations between neonatal magnetic resonance imaging and short- and long-term neurodevelopmental outcomes in a longitudinal cohort of very preterm children. J Pediatr. 234:46-53.e2, 2021
Neil JJ et al: Diffusion magnetic resonance imaging of infants. Magn Reson Imaging Clin N Am. 29(2):185-93, 2021
Agut T et al: Preterm white matter injury: ultrasound diagnosis and classification. Pediatr Res. 87(Suppl 1):37-49, 2020
Benninger KL et al: MR imaging scoring system for white matter injury after deep medullary vein thrombosis and infarction in neonates. AJNR Am J Neuroradiol. 40(2):347-52, 2019
Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
Kendall GS et al: White matter NAA/Cho and Cho/Cr ratios at MR spectroscopy are predictive of motor outcome in preterm infants. Radiology. 271(1):230-8, 2014
Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
de Bruïne FT et al: Clinical implications of MR imaging findings in the white matter in very preterm infants: a 2-year follow-up study. Radiology. 261(3):899-906, 2011
van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
van Wezel-Meijler G et al: Ultrasound detection of white matter injury in very preterm neonates: practical implications. Dev Med Child Neurol. 53 Suppl 4:29-34, 2011
Volpe JJ et al: The developing oligodendrocyte: key cellular target in brain injury in the premature infant. Int J Dev Neurosci. 29(4):423-40, 2011
Kato A et al: Relationship between enlargement of the lateral ventricle and periventricular leukomalacia in infants. J Obstet Gynaecol Res. 36(5):984-90, 2010
Leijser LM et al: Is sequential cranial ultrasound reliable for detection of white matter injury in very preterm infants? Neuroradiology. 52(5):397-406, 2010
Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
Ment LR et al: Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 58(12):1726-38, 2002
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