Cystic periventricular leukomalacia: magnetic resonance imaging changes and motor development outcomes in neonates at different stages after birth

Abstract

Objective To compare the magnetic resonance imagings (MRI) of neonates diagnosed with cystic periventricular leukomalacia (cPVL) at different stages after birth, and to clarify the relationship of MRI and motor development outcomes. Method Data of neonates admitted to the Shengjing Hospital of China Medical Univerisity from January 2010 to May 2015 diagnosed with cPVL by MRI were studied retrospectively. Subjects were assigned into two groups according to time of diagnosis: early-diagnosed group (≤7 d) and late-diagnosed group (>7 d). The MRI and subsequent motor development outcome were compared between two groups. Result There were 35 neonates in early-diagnosed group. The cysts were mainly located in the anterior horn of the lateral ventricle (35 infants), the body of the lateral ventricle (2 infants) and the centrum semiovale (1 infants). Only one cyst were found in 17 infants, two cysts in 14 infants, three or more cysts in 4 infants. There were 45 cases in the late-diagnosed group, the cysts were mainly located in the centrum semiovale (35 infants) and the posterior horn of the lateral ventricle (34 infants), the body (20 infants) and the anterior horn (10 infants) of lateral ventricle. Only one cyst were found in 3 infants, two cysts in 5 infants, three or more cysts in 37 infants. Among the 23 infants in the early-diagnosed group with follow-up, 22 infants are clinically normal, one infant with spastic diplegia (4.3%). Among the 24 infants in the late-diagnosed group with followe-up, 4 infants are clinically normal, 20 infants with spastic hemiplegia, diplegia or quadriplegia (83.3%). There are significant differences of incidence of cerebral palsy between the two group (P<0.05). Conclusion MRI imaging showed that the location, number of cysts are different between the early-diagnosed and late-diagnosed group, and the motor development outcome of the early-diagnosed group are better, which indicates the prognosis of cPVL that occurred in utero are better than acquired cPVL after birth. Key words: Leukomalacia, periventricular; Magnetic resonance imaging; Cystic; Motor development outcome