Periventricular leukomalacia in premature infants: value of US and MRI forprognosis

Purpose:To evaluate the role of cranial US and MRI to establish the neurolo gical prognosis of premature infants with periventricular leukomalacia (PVL ). Patients and methods : Follow-up results of cranial US and early MRI evalua tion (before 25 weeks*) of 28 premature infants were retrospectively review ed and compared to the neurological outcome at 18 months* (*corrected age). Results: Follow-up by cranial US was more sensitive (8/28) than early MRI t o detect cystic PVL lesions because of the transient nature of these cysts. This has prognostic implications since all patients (8/8) with cystic PVL lesions had neurological sequelae. MRI was useful, as a complement to crani al US, for the evaluation of non-cystic PVL lesions. Indeed, patients with evidence of hemorrhage or paucity of white matter at MRI had a higher risk of neurological sequelae (9/11) than infants with echogenic periventricular white matter at US without evidence of white matter abnormality at MRI (p < 0.013). Conclusion : MRI was useful, as a complement to cranial US, to evaluate the prognosis of infants with non-cystic PVL lesions.