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Quantitative analysis of cranial ultrasonographic periventricular echogenicity in relation to early neuromotor development in preterm infants
  1. Tammy Beller1,2,
  2. Tali Peylan1,
  3. Liat Ben Sira2,3,
  4. Shelly Irene Shiran2,3,
  5. Loren Levi1,
  6. Haim Bassan1,2
  1. 1Child Neurology and Development Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  2. 2Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  3. 3Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  1. Correspondence to Dr Haim Bassan, Neonatal Neurology Service, Child Neurology and Development Unit, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv 64239, Israel; bassan{at}


Background Periventricular white matter (WM) hyperechoic flares that do not evolve into cystic lesion(s) are frequently encountered on cranial ultrasonography (CUS) of preterm infants. Subjective interpretation of its presence, however, is challenging and its association with maturation and neurodevelopment remains undefined.

Objectives To determine the relationship between quantitative WM echogenicity and postnatal and postmenstrual ages and the relationship between quantitative WM echogenicity and neuromotor development at term equivalent.

Methods We measured the mean pixel brightness intensity at the frontoparietal and parieto-occipital WM, choroid plexus and calvarium bone on sequential neonatal CUS scans of preterm infants born at <34 weeks gestation. The relative echogenicity (RE) was derived by dividing the mean WM echogenicity to that of the choroid plexus (RECP) or bone (REBN). The Lacey Assessment of the Preterm Infant was administered before discharge.

Results 58 preterm infants (the mean gestational age 30.6±2.3 weeks and the mean birth weight 1211.9±224.7 g) were included. The RECP of the frontoparietal WM decreased significantly with advancing postnatal and postmenstrual ages (r=−0.4, p<0.0001). The REBN values of the frontoparietal and parieto-occipital WM during intermediate and late predischarge CUS studies, respectively, were significantly associated with neuromotor status at term (p<0.05). The RECP and REBN measured during the first week of life were not associated with neuromotor status at term.

Conclusions Quantitative measurements of the periventricular WM echogenicity are feasible in neonatal CUSs of premature infants and may reflect microstructural developmental changes. An optimal echogenicity quantification technique and its correlation with long-term outcome remain to be determined.

  • preterm
  • cranial ultrasonography
  • echogenicity
  • quantitative
  • Neurodevelopment

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