Abstract
Cerebral ultrasound of preterm infants may show diffuse, bilateral, hyperechogenic
“haze” over the thalami and basal ganglia (hyperechogenicity BGT). We explored whether
this could be a pathological phenomenon. All cerebral ultrasound examinations performed
in 2001 on infants < 35 weeks of age were reviewed. This resulted in a hyperechogenicity
and non-hyperechogenicity group. The character of the hyperechogenicity BGT and the
presence of concomitant brain lesions were noted. Detailed clinical and follow-up
data from a selected group of infants < 32 weeks were reviewed and compared between
the 2 groups. The incidence of hyperechogenicity BGT was 11 % (39/359) in infants
< 35 weeks and 26 % (37/143) in infants < 32 weeks. Birth weight and gestational age
were significantly lower and clinical course was more complicated in the hyperechogenicity
group. Concomitant brain lesions were always present. In 12/39 infants with hyperechogenicity
BGT, MRI (always performed for other reasons) was available, showing signal intensity
changes in thalamic region in 5 infants. The neurological outcome at term was less
favorable in the hyperechogenicity group, but similar at 1 year. Thus hyperechogenicity
BGT mainly occurred in very small, sick infants and was always associated with cerebral
pathology. MRI did not consistently show abnormalities in the thalamic region. It
was not associated with a poorer outcome at 1 year.
Key words
Preterm infants - thalamus and basal ganglia - cerebral ultrasonography
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G. van Wezel-Meijler
Department of Pediatrics
Subdivision of Neonatology
Leiden University Medical Center
Albinusdreef 2
P.O. Box 9600
2300 RC Leiden
The Netherlands
Email: G.van_Wezel-Meijler@lumc.nl