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(Radiology. 2000;214:199-204.)
© RSNA, 2000


Pediatric Imaging

Periventricular Leukomalacia: Relationship between Lateral Ventricular Volume on Brain MR Images and Severity of Cognitive and Motor Impairment1

Elias R. Melhem, MD, Alexander H. Hoon, Jr, MD, Joseph T. Ferrucci, Jr, MD, Cynthia B. Quinn, BS, Elsie M. Reinhardt, BS, Susan W. Demetrides, BS, Bethany M. Freeman, BS and Michael V. Johnston, MD

1 From the Departments of Radiology (E.R.M., J.T.F., C.B.Q.), Neurology (M.V.J.), and Pediatrics (A.H.H., M.V.J.); the Departments of Neurology and Developmental Medicine (A.H.H., M.V.J.) and Nursing (E.M.R., S.W.D.), Kennedy Krieger Institute; and the School of Medicine (B.M.F.), Johns Hopkins Medical Institutions, 600 N Wolfe St, Houck Bldg B100G, Baltimore, MD 21287-2182. Received January 8, 1999; revision requested March 9; revision received March 22; accepted July 1. A.H.H. and M.V.J. supported in part by the United Cerebral Palsy Research and Education Foundation grant no. R-706-96. Address reprint requests to E.R.M. (e-mail: emelhem@rad.jhu.edu).

PURPOSE: To evaluate the utility of lateral ventricular volume measurements in predicting motor and cognitive impairment severity in children with periventricular leukomalacia (PVL), with or without seizures.

MATERIALS AND METHODS: The charts of children with spastic cerebral palsy and PVL documented on brain magnetic resonance (MR) images were reviewed. Affected children were grouped by motor and cognitive impairment severity and seizure disorder. An age-matched control group was established. Lateral ventricular volumes were measured on two-dimensional T2-weighted spin-echo MR images. Analysis of variance was used to identify significant differences in mean lateral ventricular volume between groups. Paired analyses of differences were performed with the Bonferroni t method.

RESULTS: Thirty-six children (24 boys, 12 girls) with spastic cerebral palsy and PVL and 21 age-matched control subjects (14 boys, seven girls) were identified. Mean lateral ventricular volumes of the moderate and marked motor deficit groups were significantly larger than those of the control and mild motor deficit groups (F = 29.24; {alpha} = .01). Mean lateral ventricular volumes of all cognitive impairment groups were significantly larger than those of the control and no-cognitive-impairment groups (F = 21.10; {alpha} = .01). There was no difference in mean lateral ventricular volume between children with PVL with or without seizures.

CONCLUSION: Lateral ventricular volume measurements can be used as quantitative markers of clinical impairment severity and as clinical outcome predictors before formal testing is possible.

Index terms: Brain, injuries, 161.5911, 161.829, 161.8729 • Cerebral palsy, 161.5911, 161.829, 161.8729 • Children, central nervous system, 161.4371, 161.829 • Fetus, abnormalities, 161.4371, 161.829 • Fetus, injuries, 161.829, 161.4371 • Leukomalacia, 161.4371, 161.829 • Magnetic resonance (MR) imaging, in infants and children, 161.121411




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