CORRELATION BETWEEN THE DEGREE OF PERIVENTRICULAR LEUKOMALACIA DIAGNOSED USING CRANIAL ULTRASOUND AND MRI LATER IN INFANCY IN CHILDREN WITHCEREBRAL-PALSY

During a period of 30 months, 504 infants of 34 weeks gestation or les s were enrolled in a prospective cranial ultrasound study. Ninety-two (18.4 %) infants developed different degrees of periventricular leukom alacia (PVL), being transient periventricular echogenicities (PVE) in 75, localised cystic lesions in 7 and extensive cysts in 10. Eight of 75 (10.6 %) infants with PVE, 4 of the 6 (66.6 %) survivors with local ised cysts and all 8 survivors with extensive cysts developed cerebral palsy in infancy and MRI studies could be performed in 15 of these 20 infants between 11 and 32 months of age. Neurological sequelae were m ost severe among the infants with extensive cysts and none were able t o walk, while 6 of the 12 who developed cerebral palsy following eithe r PVE or localised cysts had learned to walk independently. There appe ared to be a good correlation between the degree of PVL, diagnosed usi ng ultrasound, and the extent of MRI changes noted in infancy. Ventric ular enlargement and delay in myelination were more common in infant.s with cystic lesions and periventricular hyperintensity (PVHI) was pre sent in all infants, but most extensive in the cases with extensive cy sts. MRI performed later in infancy may, even in the absence of neonat al cranial ultrasound, provide information about both the presence as well as the degree of leukomalacia, which the child may have suffered in the neonatal or antenatal period.