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Neuropediatrics 2017; 48(02): 086-090
DOI: 10.1055/s-0036-1597613
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Diffusion-Weighted Imaging of Periventricular Leukomalacia in Very Young Children: Assessment of Peritrigonal Stripe of Restricted Diffusion

Ping-Sheng Lu
1   Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan
,
Cheng-Hong Toh
1   Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan
,
Chih-Hua Yeh
1   Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan
,
Huei-Shyong Wang
2   Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
,
Kuang-Lin Lin
2   Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan
,
Alex Mun-Ching Wong
1   Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan
› Author Affiliations
Further Information

Publication History

29 July 2016

08 November 2016

Publication Date:
28 December 2016 (online)

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Abstract

Purpose In periventricular leukomalacia (PVL), apparent diffusion coefficient (ADC) reduction, normally shown as dark stripe in the peritrigonal (PT) white matter, may be incomplete. We assessed the PT dark stripe to differentiate between PVL patients and control subjects.

Patients and Methods We reviewed the magnetic resonance studies of 27 neonates and young children with PVL and 67 control subjects to assess the PT dark stripe on ADC maps. In PVL patients, the assessment was referred to the location of PVL lesion on fluid-attenuated inversion recovery (FLAIR) imaging. In the controls, the PT region or the location corresponding to FLAIR hyperintensity was evaluated for the dark stripe. We compared the prevalence of the dark stripe on ADC map and the PT FLAIR hyperintensity between the PVL and the control subjects.

Results On ADC map, complete PT dark stripe was present in 67 (100%) of 67 controls but only in 4 (14.8%) of 27 PVL patients (p-value < 0.01), with sensitivity of 0.85, specificity of 1.0, and accuracy of 0.96. PT FLAIR hyperintensity was present in 44 (65.7%) of 67 controls and in 18 (66.7%) of 27 PVL patients (p = 0.920).

Conclusion PVL patients can be differentiated from the control subjects with PT dark stripe on ADC map.

Keywords

periventricular leukomalacia - diffusion-weighted imaging - PT dark stripe - apparent diffusion coefficient
 

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