Punctate white matter lesions in infants: new insights using susceptibility-weighted imagingReport as inadecuate

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, 53:669

First Online: 07 May 2011Received: 22 October 2010Accepted: 11 April 2011


IntroductionPunctate white matter lesions PWML are recognized with magnetic resonance imaging MRI as hypersignal on T1-weighted imaging and hyposignal on T2-weighted imaging. Our aim was to assess how often a hemorrhagic component was present in PWML using susceptibility-weighted imaging SWI.

MethodsSeventeen preterm gestational age, 25–34 weeks and seven full-term infants age at MRI, 37–42 weeks with PWML were included. Seven preterm infants had sequential MRIs. PWML were diagnosed with conventional MRI and compared with SWI, where signal loss is suggestive of hemorrhage. The pattern of associated brain lesions was taken into account, and the percentage of lesions with signal loss on SWI was calculated for each infant.

ResultsA significantly higher percentage of signal loss on SWI median, 93.9% was found among infants with germinal matrix and intraventricular hemorrhage as the primary diagnosis n = 8 compared to those with a primary diagnosis of white matter injury n = 14; median, 14.2%; p < 0.01. In the infants with serial MRIs, a reduction in the number of PWML and-or signal loss on SWI was noted at term equivalent age. In the patient who died, cystic lesions, associated with hemorrhage and gliosis, were demonstrated on histology.

ConclusionsSWI can distinguish hemorrhagic and non-hemorrhagic PWML. Signal loss on SWI was more common when PWML were associated with an intraventricular hemorrhage. Longitudinal imaging showed a decrease in the number of PWML over time, with some PWML no longer showing signal loss on SWI, suggesting early gliosis.

KeywordsPunctate white matter lesions Neonate Susceptibility-weighted imaging Hemorrhage AbbreviationsPWMLPunctate white matter lesions

SWISusceptibility-weighted imaging

MRIMagnetic resonance imaging

IRInversion recovery

SENSESensitivity encoding

TEATerm equivalent age

PMAPostmenstrual age

Electronic supplementary materialThe online version of this article doi:10.1007-s00234-011-0872-0 contains supplementary material, which is available to authorized users.

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Author: Tetsu Niwa - Linda S. de Vries - Manon J. N. L. Benders - Taro Takahara - Peter G. J. Nikkels - Floris Groenendaal

Source: https://link.springer.com/

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