title: Diffusion-Weighted Imaging of Periventricular Leukomalacia in Very Young Children: Assessment of Peritrigonal Stripe of Restricted Diffusion.
abstract: PurposeIn periventricular leukomalacia (PVL), apparent diffusion coefficient (ADC) reduction, normally shown as dark stripe in the peritrigonal (PT) white matter, may be incomplete. We assessed the PT dark stripe to differentiate between PVL patients and control subjects.Patients and MethodsWe reviewed the magnetic resonance studies of 27 neonates and young children with PVL and 67 control subjects to assess the PT dark stripe on ADC maps. In PVL patients, the assessment was referred to the location of PVL lesion on fluid-attenuated inversion recovery (FLAIR) imaging. In the controls, the PT region or the location corresponding to FLAIR hyperintensity was evaluated for the dark stripe. We compared the prevalence of the dark stripe on ADC map and the PT FLAIR hyperintensity between the PVL and the control subjects.ResultsOn ADC map, complete PT dark stripe was present in 67 (100%) of 67 controls but only in 4 (14.8%) of 27 PVL patients (p-value < 0.01), with sensitivity of 0.85, specificity of 1.0, and accuracy of 0.96. PT FLAIR hyperintensity was present in 44 (65.7%) of 67 controls and in 18 (66.7%) of 27 PVL patients (p= 0.920).ConclusionPVL patients can be differentiated from the control subjects with PT dark stripe on ADC map.
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan.
authors.forename: Ping-Sheng
authors.initials: PS
authors.lastname: Lu
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan.
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Toh
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan.
authors.forename: Chih-Hua
authors.initials: CH
authors.lastname: Yeh
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan.
authors.forename: Huei-Shyong
authors.initials: HS
authors.lastname: Wang
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Linkou, Taiwan.
authors.forename: Kuang-Lin
authors.initials: KL
authors.lastname: Lin
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung/Linkou, and Chang Gung University, Taiwan.
authors.forename: Alex Mun-Ching
authors.initials: AM
authors.lastname: Wong
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging*; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity