Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants.
OBJECTIVE
To determine the incidence and factors associated with diffuse basal ganglia or thalamus hyperechogenicity (BGTH) in preterm infants.


METHODS
(1) Review of serial neurosonograms among neonates with gestational age (GA) <34 weeks born at Weiler Hospital during a 21-month period; (2) Color Doppler flow imaging; (3) Case-control study using GA group-matched controls; and (4) Blind reading of CT scans or MRIs in patients with BGTH.


RESULTS
Among 289 infants, 24 (8.3%) had diffuse BGTH. Color Doppler flow imaging was normal in nine patients. The incidence of diffuse BGTH was inversely related to GA (P<0.01). Logistic regression (n=96) showed that diffuse BGTH was significantly associated with requirement of high-frequency oscillation (HFO) (P=0.031), severe intraventricular hemorrhage (IVH) (P=0.004), hypotension requiring vasopressors (P=0.040), hypoglycemia (P=0.031) and male gender (P=0.014). Most patients with diffuse BGTH had normal basal ganglia and thalamus on CT/MRI, one had a hemorrhage, and one had an ischemic infarction.


CONCLUSIONS
In our series, diffuse BGTH occurred in 8.3%, and was associated with factors similar to those previously reported. In contrast, several series have reported almost exclusively linear or punctuate hyperechoic foci, corresponding to hyperechogenicity of the lenticulostriate vessels. Our data provide further evidence to suggest that diffuse BGTH and hyperechogenicity of the lenticulostriate vessels are two different entities. Additional studies are required to determine the long-term significance of diffuse BGTH.
Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY 10461, USA.
L M
LM
Soghier
M
M
Vega
K
K
Aref
G T
GT
Reinersman
M
M
Koenigsberg
M
M
Kogan
J
J
Bello
J
J
Romano
T
T
Hoffman
L P
LP
Brion
D001479:Basal Ganglia / Q000000981:diagnostic imaging*; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002421:Caudate Nucleus / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D004453:Echoencephalography / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D013786:Thalamic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D013788:Thalamus / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed