Radiology Clinic, Edirne Sultan 1. Murat State Hospital, Edirne, 22030, Turkey.
Faculty of Medicine, Department of Radiology, Erciyes University, Kayseri, Turkey.
Radiol Med. 2018 Jun;123(6):434-440. doi: 10.1007/s11547-018-0861-z. Epub 2018 Feb 1.
To assess symmetrical increased echogenicity of bilateral caudothalamic grooves (SIEBCG) detected on newborn cranial ultrasonography (CUS) using magnetic resonance susceptibility-weighted imaging (SWI).
A total of 14 newborns (8 girls; 12 premature with mean gestational age of 30 weeks and 5 days, 2 mature) who were detected to have SIEBCG on routine serial CUS and underwent cranial magnetic resonance imaging (MRI) were recruited for the study. The cranial MRI examinations including SWI acquired on the same day of SIEBCG detection and serial CUS to assess the progress of SIEBCG lesions in the following 6 month period were retrospectively evaluated and compared for the presence of germinal matrix hemorrhage.
On SWI, solely one patient (7, 1%) had signal alteration on caudothalamic groove compatible with grade 1 germinal matrix hemorrhage. Two patients (14, 2%) had parenchymal (on cerebellar and parietal white matter) millimetric hemorrhagic foci. Seven patients (50%) had signs of presumptive hypoxic insult including hyperintense dots on centrum semiovale and periventricular white matter in five, and increased signal intensity on the globus pallidi in two, on T1-weighted images. Four patients (28, 6%) had normal findings. Of these, 10 patients became normal on follow-up CUS at postterm-equivalent age, whereas four were missing.
Symmetrical increased echogenicity of bilateral caudothalamic grooves seen on newborn CUS may be the indicator of other pathologies as ischemic insult or focal parenchymal hemorrhage. In the presence of SIEBCG, further examination with SWI should be performed.
利用磁共振磁敏感加权成像(SWI)评估新生儿颅脑超声(CUS)检测到的双侧尾状丘脑沟回声增强(SIEBCG)。
共纳入 14 名新生儿(8 名女孩;12 名早产儿,平均胎龄为 30 周零 5 天,2 名足月),这些新生儿在常规连续 CUS 上检测到 SIEBCG,并进行了颅脑磁共振成像(MRI)检查。回顾性评估并比较了同一天进行的 SWI 与连续 CUS 检查,以评估 SIEBCG 病变在接下来的 6 个月内的进展情况,并评估有无脑室内出血。
在 SWI 上,仅有 1 名患者(7%,1 例)的尾状丘脑沟信号改变,符合 1 级脑室内出血。2 名患者(14%,2 例)有毫米级的脑实质(小脑和顶叶白质)出血灶。7 名患者(50%)存在缺氧性损伤的征象,包括 5 例半卵圆中心和脑室周围白质高信号点,2 例苍白球高信号强度。4 名患者(28%,4 例)未见异常。其中,10 名患者在足月后行 CUS 随访,结果转为正常,而 4 名患者失访。
新生儿 CUS 上双侧尾状丘脑沟回声增强可能是缺血性损伤或局灶性脑实质出血等其他病变的标志。在存在 SIEBCG 的情况下,应进一步进行 SWI 检查。