Volumetric brain differences in children with periventricular T2-signal hyperintensities: A grouping by gestational age at birth.

OBJECTIVE. The purpose of this study was to compare both the volumes of the lateral ventricles and the cerebral white matter with gestational age at b irth of children with periventricular white matter (PVWM) T2-signal hyperin tensities on MR images. The spectrum of neuromotor abnormalities associated with these hyperintensities was also determined. MATERIALS AND METHODS. We retrospectively reviewed the MR images of 70 pati ents who were between the ages of 1 and 5 years and whose images showed PVW M T2-signal hyperintensities. The patients were divided into premature (n = 35 children) and term (n = 35) groups depending on their gestational age a t birth. Volumetric analysis was performed on four standardized axial secti ons using T2-weighted images. Volumes of interest were digitized on the bas is of gray-scale densities of signal intensities to define the hemispheric cerebral white matter and lateral ventricles. Age-adjusted comparisons of v olumetric measurements between the premature and term groups were pet-forme d using analysis, of covariance. RESULTS. The volume of the cerebral white matter was smaller in the prematu re group (54 +/- 2 cm(3)) than in the term group (79 +/- 3 cm(3), p < 0.000 1). The volume of the lateral ventricles was greater among the patients in the premature group (30 +/- 2 cm(3)) than among those in the term group (13 +/- 1 cm(3), p < 0.0001). Fifty percent of all the premature children had spastic diplegia or quadriplegia. Thirty-two percent of all the term childr en had hypotonia. There were patients in both groups whose PVWM T2-signal h yperintensities did not correlate with any neuromotor abnormalities but wer e associated with seizures or developmental delays. CONCLUSION. The differences in volumetric measurements of cerebral white ma tter and lateral ventricles in children with PVWM T2-signal hyperintensitie s are related to their gestational age at birth. Several neurologic motor a bnormalities are found in children with such hyperintensities.