Volumetric Brain Differences in Children with Periventricular T2-Signal Hyperintensities
A Grouping by Gestational Age at Birth
Ashok Panigrahy1,
Patrick D. Barnes2,
Richard L. Robertson3,
Stephen A. Back4,
Lynn A. Sleeper5,
James W. Sayre1,6,
Hannah C. Kinney7 and
Joseph J. Volpe8
1
Department of Radiological Sciences, University of California at Los Angeles
Medical Center, 10833 Le Conte Ave., Los Angeles, CA 90095-1721.
2
Department of Radiology, Lucile Salter Packard Children's Hospital, Stanford
University Medical Center, 725 Welch Rd., Palo Alto, CA 94304.
3
Department of Radiology, Children's Hospital Boston, 300 Longwood Ave.,
Boston, MA 02115.
4
Department of Pediatrics, Oregon Health Science University, 707 S.W. Gaines
Rd., Portland, OR 97201.
5
New England Research Institute, 9 Galen St., Watertown, MA 02472.
6
Department of Biostatistics, University of California at Los Angeles Medical
Center, Los Angeles, CA 90095.
7
Department of Pathology, Children's Hospital, Boston, MA 02115.
8
Department of Neurology, Children's Hospital, Boston, MA 02115.
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Fig. 1A. —Full-term male infant who presented with hypotonia and
developmental delay. Axial T2-weighted MR image (TR/TEeff, 3400/84;
1 excitation) obtained when patient was 5 months old shows high T2-signal
corresponding to predominately unmyelinated white matter in periventricular
trigonal white matter region.
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Fig. 1B. —Full-term male infant who presented with hypotonia and
developmental delay. Axial T2-weighted image (TR/TEeff, 3400/84; 1
excitation) obtained when patient was 24 months old shows abnormal
periventricular white matter T2-signal hyperintensities corresponding to
myelinated white matter in region of trigone clearly distinguished from
surrounding low T2 signal.
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Fig. 2A. —16-month-old full-term girl with developmental delay. Axial
T2-weighted image (TR/TEeff, 3400/84; 1 excitation) slightly
superior to level of trigone reveals periventricular white matter (PVWM)
T2-signal hyperintensity;
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Fig. 2B. —16-month-old full-term girl with developmental delay.
Corresponding axial fluid-attenuated inversion recovery image also shows PVWM
T2-signal hyperintensity.
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Fig. 3. —Axial T2-weighted image (TR/TEeff, 3400/84; 1
excitation) of 15-month-old full-term boy with hypotonia reveals
periventricular white matter T2-signal hyperintensity posterolateral to body
of lateral ventricles, superior to level of trigone. This level is most
superior in relation to trigone of four levels used in volumetric
analysis.
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Fig. 4A. —16-month-old premature girl (born at 31 weeks of gestation)
with spastic diplegia. Axial T2-weighted image (TR/TEeff, 3400/84;
1 excitation) reveals periventricular white matter (PVWM) T2-signal
hyperintensity.
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Fig. 4B. —16-month-old premature girl (born at 31 weeks of gestation)
with spastic diplegia. Corresponding axial fluid-attenuated inversion recovery
image shows abnormal PVWM T2-signal hyperintensity. In this premature patient,
loss of cerebral white matter and ventriculomegaly are apparent when compared
with age-matched full-term patients depicted in Figures
2A,2B
and 3.
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Fig. 5A. —22-month-old full-term girl with developmental delay. Axial
T2-weighted image (TR/TEeff, 3400/84; 1 excitation) obtained at
level of trigone reveals periventricular white matter (PVWM) T2-signal
hyperintensity.
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Fig. 5B. —22-month-old full-term girl with developmental delay.
Corresponding axial proton density image obtained at level of trigone also
reveals PVWM T2-signal hyperintensity.
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Fig. 5C. —22-month-old full-term girl with developmental delay. Axial
T2-weighted image obtained at level of body of lateral ventricle also shows
PVWM T2-weighted hyperintensity.
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Fig. 6A. —22-month-old premature boy (born at 31 weeks of gestation)
with spastic diplegia. Axial T2-weighted image (TR/TEeff, 3400/84;
1 excitation) shows periventricular white matter (PVWM) T2-signal
hyperintensity.
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Fig. 6B. —22-month-old premature boy (born at 31 weeks of gestation)
with spastic diplegia. Corresponding axial fluid-attenuated inversion recovery
image reveals PVWM T2-signal hyperintensity. In this premature patient, loss
of cerebral white matter and ventriculomegaly are apparent when compared with
agematched full-term patient depicted in Figure
5A,5B,5C.
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Fig. 7. —Scatterplot shows cerebral white matter volumes of premature
and term patients with abnormal periventricular white matter (PVWM) T2-signal
hyperintensities. In both groups of patients, volume of cerebral white matter
increases with age, but volume of cerebral white matter in full-term patients
increases at greater rate than that of premature patients. [UNK] = preterm
children;  = term children.
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Fig. 8. —Scatterplot shows lateral ventricle volumes of premature and
term patients with abnormal periventricular white matter (PVWM) T2-signal
hyperintensities. In full-term patients, volume of lateral ventricle decreases
slightly with age whereas in premature patients, volume of lateral ventricle
increases with age. [UNK] = preterm children; = term children.
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Copyright © 2001 by the American Roentgen Ray Society.
