Abstract
To evaluate the severity of punctate white matter lesions (PWML) in neonatal brain injury with susceptibility weighted imaging (SWI) and explore the value and limitation of SWI versus the conventional magnetic resonance imaging (MRI). A total of 34 neonates presenting with PWML at initial MRI were recruited for this prospective study. PWML were defined as punctuate lesions with T(1) hyperintensity and T(2) isointensity or hypointensity in white matter. There were 21 males and 13 females with a median age of 9.24 days (range: 2 - 17 days). All MRI examinations were performed at 1.5 Tesla unit including conventional MRI (T(1), T(2) & Flair sequences), DWI and SWI. PWML were classified into two groups: (1) T(1) hyperintensity & T(2) isointensity; (2) T(1) hyperintensity & T(2) hypointensity. The manifestations of PWML on SWI were analyzed. Among all cases, only 5 cases (14.7%) demonstrated an evidence of hemorrhage on SWI. There were 7 cases in Group 1. Only 1 case showed punctate hypointensity in the areas of PWML on SWI while there was no hemorrhage on SWI in other 6 cases. Twenty-seven cases were in Group 2. Only 4 cases showed an evidence of hemorrhage on SWI while hemorrhage was absent on SWI in other 23 cases. Most areas of PWML in neonatal brain show no hemorrhage on SWI. And SWI can help to identify whether or not hemorrhage is present in PWML of neonates.
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