Original Article

Journal of Perinatology (2006) 26, 230–236. doi:10.1038/sj.jp.7211460; published online 23 February 2006

Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

L M Soghier1,3, M Vega1, K Aref1,4, G T Reinersman1, M Koenigsberg2, M Kogan2, J Bello2, J Romano2, T Hoffman2 and L P Brion1

  1. 1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
  2. 2Department of Radiology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA

Correspondence: Dr LP Brion, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Weiler Hospital, 1825 Eastchester Road, Suite 725, Bronx, NY 10461, USA. E-mail: lbrion@montefiore.org

3Current address: Children's Hospital of Philadelphia, Philadelphia, PA, USA.

4Current address: Practicing Pediatrics in Edmundston, New Brunswick, Canada.

Received 21 October 2005; Revised 19 January 2006; Accepted 24 January 2006; Published online 23 February 2006.

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Abstract

Objective:

 

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

Study Design:

 

(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.

Keywords:

basal ganglia, caudate nucleus, thalamus, preterm, logistic regression, hyperechogenicity

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