title: Quantitative analysis of cranial ultrasonographic periventricular echogenicity in relation to early neuromotor development in preterm infants.
abstract: BACKGROUND
  Periventricular white matter (WM) hyperechoic flares that do not evolve into cystic lesion(s) are frequently encountered on cranial ultrasonography (CUS) of preterm infants. Subjective interpretation of its presence, however, is challenging and its association with maturation and neurodevelopment remains undefined.
  
  
  OBJECTIVE
  To determine the relationship between quantitative WM echogenicity and postnatal and postmenstrual ages and the relationship between quantitative WM echogenicity and neuromotor development at term equivalent.
  
  
  METHODS
  We measured the mean pixel brightness intensity at the frontoparietal and parieto-occipital WM, choroid plexus and calvarium bone on sequential neonatal CUS scans of preterm infants born at <34 weeks gestation. The relative echogenicity (RE) was derived by dividing the mean WM echogenicity to that of the choroid plexus (RE(CP)) or bone (RE(BN)). The Lacey Assessment of the Preterm Infant was administered before discharge.
  
  
  RESULTS
  58 preterm infants (the mean gestational age 30.6±2.3 weeks and the mean birth weight 1211.9±224.7 g) were included. The RE(CP) of the frontoparietal WM decreased significantly with advancing postnatal and postmenstrual ages (r=-0.4, p<0.0001). The RE(BN) values of the frontoparietal and parieto-occipital WM during intermediate and late predischarge CUS studies, respectively, were significantly associated with neuromotor status at term (p<0.05). The RE(CP) and RE(BN) measured during the first week of life were not associated with neuromotor status at term.
  
  
  CONCLUSIONS
  Quantitative measurements of the periventricular WM echogenicity are feasible in neonatal CUSs of premature infants and may reflect microstructural developmental changes. An optimal echogenicity quantification technique and its correlation with long-term outcome remain to be determined.
authors: Child Neurology and Development Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Tammy
authors: T
authors: Beller
authors: Child Neurology and Development Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Tali
authors: T
authors: Peylan
authors: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Liat
authors: L
authors: Ben Sira
authors: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Department of Radiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Shelly Irene
authors: SI
authors: Shiran
authors: Child Neurology and Development Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors: Loren
authors: L
authors: Levi
authors: Child Neurology and Development Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Haim
authors: H
authors: Bassan
mesh_terms: D002657:Child Development / Q000502:physiology*; D002831:Choroid Plexus / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D011247:Pregnancy; D011446:Prospective Studies; D012886:Skull / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Neurodevelopment; cranial ultrasonography; echogenicity; preterm; quantitative