Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study

Background: Lenticulostriate vasculopathy (LSV) is a hyperechogenicity of the lenticulostriate branches of the basal ganglia and/or thalamus' middle cerebral arteries and is frequently seen in neonatology. Our study primarily describes the perinatal data and long-term follow-up of newborns with...

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Main Authors: Candice Fabre, Barthélémy Tosello, Estelle Pipon, Catherine Gire, Kathia Chaumoitre
Format: Article
Language:English
Published: Elsevier 2018-12-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957217303248
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author Candice Fabre
Barthélémy Tosello
Estelle Pipon
Catherine Gire
Kathia Chaumoitre
author_facet Candice Fabre
Barthélémy Tosello
Estelle Pipon
Catherine Gire
Kathia Chaumoitre
author_sort Candice Fabre
collection DOAJ
description Background: Lenticulostriate vasculopathy (LSV) is a hyperechogenicity of the lenticulostriate branches of the basal ganglia and/or thalamus' middle cerebral arteries and is frequently seen in neonatology. Our study primarily describes the perinatal data and long-term follow-up of newborns with lenticulostriate vessel hyperechoic degeneration. Secondly, it describes the cerebral imaging data as a function of perinatal factors and neurodevelopmental follow-up of these newborns. Methods: This retrospective study assesses the outcome of newborns with LSV hyperechogenicity on cerebral ultrasound (two grades). These children were born between January 2008 and September 2015 and were treated in a large level III neonatal intensive care unit. Thirty-four term-equivalent age children underwent MRIs using a standardized protocol of T2, T1 3D, diffusion and spectro-MRI sequences. The MRIs retrospectively measured the white matter and basal ganglia apparent diffusion coefficients (ADC). Results: Fifty-eight neonates, ranging from 25 to 42 weeks gestational age (GA), were diagnosed with LSV. There was a significantly increased high-grade LSV when accompanied by fetal heart rate abnormalities (p = 0.03) and the neonate's need for respiratory support at birth (P = 0.002). The mean ADC score was substantially superior in the high-grade versus the low-grade LSVs (p = 0.023). There were no noteworthy outcome differences between a high and low grade LSV. The mean ADC for basal ganglions was appreciably higher in children with a severe prognoses (death or developmental disorder) as compared to children with no abnormalities (p < 0.01). Conclusion: From the results of our study, it appears that a low-grade LSV could be considered as a normal variant. There are no unifying diagnostic criteria for LSV on cerebral ultrasound. With a cerebral MRI, the use of ADC values of basal ganglia may well underscore the importance of such data in predicting long-term outcomes. Keywords: lenticulostriate vasculopathy, magnetic resonance imaging, newborn, outcome
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spelling doaj-art-805d4e5db8ce43d6a3050de9f45a65a32025-08-20T03:09:55ZengElsevierPediatrics and Neonatology1875-95722018-12-0159655356010.1016/j.pedneo.2018.01.002Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective studyCandice Fabre0Barthélémy Tosello1Estelle Pipon2Catherine Gire3Kathia Chaumoitre4Department of Neonatology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, FranceDepartment of Neonatology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France; Aix Marseille University, UMR 7268 ADÉS/EFS/CNRS, Marseille, France; Corresponding author. Department of Neonatology, Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Chemin des Bourrely, 13015, Marseille. France.Department of Medical Imaging, APHM, Hôpital Nord, 13015, Marseille, FranceDepartment of Neonatology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, FranceAix Marseille University, UMR 7268 ADÉS/EFS/CNRS, Marseille, France; Department of Medical Imaging, APHM, Hôpital Nord, 13015, Marseille, FranceBackground: Lenticulostriate vasculopathy (LSV) is a hyperechogenicity of the lenticulostriate branches of the basal ganglia and/or thalamus' middle cerebral arteries and is frequently seen in neonatology. Our study primarily describes the perinatal data and long-term follow-up of newborns with lenticulostriate vessel hyperechoic degeneration. Secondly, it describes the cerebral imaging data as a function of perinatal factors and neurodevelopmental follow-up of these newborns. Methods: This retrospective study assesses the outcome of newborns with LSV hyperechogenicity on cerebral ultrasound (two grades). These children were born between January 2008 and September 2015 and were treated in a large level III neonatal intensive care unit. Thirty-four term-equivalent age children underwent MRIs using a standardized protocol of T2, T1 3D, diffusion and spectro-MRI sequences. The MRIs retrospectively measured the white matter and basal ganglia apparent diffusion coefficients (ADC). Results: Fifty-eight neonates, ranging from 25 to 42 weeks gestational age (GA), were diagnosed with LSV. There was a significantly increased high-grade LSV when accompanied by fetal heart rate abnormalities (p = 0.03) and the neonate's need for respiratory support at birth (P = 0.002). The mean ADC score was substantially superior in the high-grade versus the low-grade LSVs (p = 0.023). There were no noteworthy outcome differences between a high and low grade LSV. The mean ADC for basal ganglions was appreciably higher in children with a severe prognoses (death or developmental disorder) as compared to children with no abnormalities (p < 0.01). Conclusion: From the results of our study, it appears that a low-grade LSV could be considered as a normal variant. There are no unifying diagnostic criteria for LSV on cerebral ultrasound. With a cerebral MRI, the use of ADC values of basal ganglia may well underscore the importance of such data in predicting long-term outcomes. Keywords: lenticulostriate vasculopathy, magnetic resonance imaging, newborn, outcomehttp://www.sciencedirect.com/science/article/pii/S1875957217303248
spellingShingle Candice Fabre
Barthélémy Tosello
Estelle Pipon
Catherine Gire
Kathia Chaumoitre
Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
Pediatrics and Neonatology
title Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
title_full Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
title_fullStr Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
title_full_unstemmed Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
title_short Hyperechogenicity of lenticulostriate vessels: A poor prognosis or a normal variant? A seven year retrospective study
title_sort hyperechogenicity of lenticulostriate vessels a poor prognosis or a normal variant a seven year retrospective study
url http://www.sciencedirect.com/science/article/pii/S1875957217303248
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