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Magnetic resonance imaging of white matter diseases of prematurity

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Abstract

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.

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Abbreviations

DEHSI:

diffuse excessive high signal intensity

DTI:

diffusion tensor imaging

GA:

gestational age

GMH:

germinal matrix haemorrhage

IUGR:

intrauterine growth restriction

IVH:

intraventricular haemorrhage

PLIC:

posterior limb of the internal capsule

PVL:

periventricular leucomalacia

WM:

white matter

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Acknowledgements

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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Authors and Affiliations

  1. Robert Steiner MR Unit, MRC Clinical Sciences Centre, Imperial College, Hammersmith Hospital, Du Cane Road, W12 OHS, London, UK

    Mary A. Rutherford, Veena Supramaniam, Ashraf Ederies, Andrew Chew, Mustafa Anjari & Serena Counsell

  2. NICU, Institute of Pediatrics and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy

    Laura Bassi, Michela Groppo & Luca A. Ramenghi

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  1. Mary A. Rutherford
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  2. Veena Supramaniam
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  5. Laura Bassi
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  9. Luca A. Ramenghi
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Correspondence to Mary A. Rutherford.

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Rutherford, M.A., Supramaniam, V., Ederies, A. et al. Magnetic resonance imaging of white matter diseases of prematurity. Neuroradiology 52, 505–521 (2010). https://doi.org/10.1007/s00234-010-0700-y

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