Rainbow Children's Hospital and Tenet Diagnostics, Hyderabad, India.
Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK.
J Child Neurol. 2022 Feb;37(2):151-167. doi: 10.1177/08830738211026052. Epub 2021 Dec 22.
Periventricular leukomalacia (PVL) is a term reserved to describe white matter injury in the premature brain. In this review article, the authors highlight the common and rare pathologies mimicking the chronic stage of PVL and propose practical clinico-radiological criteria that would aid in diagnosis and management.
The authors first describe the typical brain MRI (magnetic resonance imaging) features of PVL. Based on their clinical presentation, pathologic entities and their neuroimaging findings were clustered into distinct categories. Three clinical subgroups were identified: healthy children, children with stable/nonprogressive neurological disorder, and those with progressive neurological disorder. The neuroradiological discriminators are described in each subgroup with relevant differential diagnoses. The mimics were broadly classified into normal variants, acquired, and inherited disorders.
The term "PVL" should be used appropriately as it reflects its pathomechanism. The phrase "white matter injury of prematurity" or "brain injury of prematurity" is more specific. Discrepancies in imaging and clinical presentation must be tread with caution and warrant further investigations to exclude other possibilities.
脑室周围白质软化症（PVL）是一个术语，用于描述早产儿脑的白质损伤。在这篇综述文章中，作者强调了常见和罕见的模仿 PVL 慢性期的病理，并提出了有助于诊断和管理的实用临床放射学标准。
作者首先描述了 PVL 的典型脑 MRI（磁共振成像）特征。根据其临床表现、病理实体及其神经影像学发现，将其分为不同的类别。确定了三个临床亚组：健康儿童、稳定/非进行性神经障碍儿童和进行性神经障碍儿童。在每个亚组中都描述了神经影像学鉴别诊断的相关内容。模仿者被广泛分为正常变异、获得性和遗传性疾病。
“PVL”一词应恰当地使用，因为它反映了其发病机制。“早产儿脑白质损伤”或“早产儿脑损伤”更具体。在影像学和临床表现上的差异必须谨慎处理，并需要进一步调查以排除其他可能性。
