, Volume 52, Issue 6, pp 505–521 | Cite as

Magnetic resonance imaging of white matter diseases of prematurity

  • Mary A. RutherfordEmail author
  • Veena Supramaniam
  • Ashraf Ederies
  • Andrew Chew
  • Laura Bassi
  • Michela Groppo
  • Mustafa Anjari
  • Serena Counsell
  • Luca A. Ramenghi
Topic Article


Periventricular leucomalacia (PVL) and parenchymal venous infarction complicating germinal matrix/intraventricular haemorrhage have long been recognised as the two significant white matter diseases responsible for the majority of cases of cerebral palsy in survivors of preterm birth. However, more recent studies using magnetic resonance imaging to assess the preterm brain have documented two new appearances, adding to the spectrum of white matter disease of prematurity: punctate white matter lesions, and diffuse excessive high signal intensity (DEHSI). These appear to be more common than PVL but less significant in terms of their impact on individual neurodevelopment. They may, however, be associated with later cognitive and behavioural disorders known to be common following preterm birth. It remains unclear whether PVL, punctate lesions, and DEHSI represent a continuum of disorders occurring as a result of a similar injurious process to the developing white matter. This review discusses the role of MR imaging in investigating these three disorders in terms of aetiology, pathology, and outcome.


Magnetic resonance imaging Prematurity Brain White matter 



diffuse excessive high signal intensity


diffusion tensor imaging


gestational age


germinal matrix haemorrhage


intrauterine growth restriction


intraventricular haemorrhage


posterior limb of the internal capsule


periventricular leucomalacia


white matter



We are grateful to The Medical Research Council, The European Leucodystrophy Association, Action Medical Research, Well Child, Philips Medical Systems, and the Biomedical Research Centre for supporting these studies.

Conflict of interest statement

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Mary A. Rutherford
    • 1
    Email author
  • Veena Supramaniam
    • 1
  • Ashraf Ederies
    • 1
  • Andrew Chew
    • 1
  • Laura Bassi
    • 2
  • Michela Groppo
    • 2
  • Mustafa Anjari
    • 1
  • Serena Counsell
    • 1
  • Luca A. Ramenghi
    • 2
  1. 1.Robert Steiner MR Unit, MRC Clinical Sciences CentreImperial College, Hammersmith HospitalLondonUK
  2. 2.NICU, Institute of Pediatrics and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina ElenaUniversity of MilanMilanItaly

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