Mi-Jung Lee, Presenter: Nothing to Disclose

Myung-Joon Kim, Abstract Co-Author: Nothing to Disclose

Seung-Koo Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Ran Namgung, Abstract Co-Author: Nothing to Disclose

Kook In Park, Abstract Co-Author: Nothing to Disclose

Lenticulostriate vasculopathy (LSV) is defined as linear or branching echogenic structures in the basal ganglia and/or thalamus on cranial ultrasonography (US) of neonates. And there are many reports about the incidence (0.3-32%), factors attributing to this finding and the clinical significance. The purpose of this study was to evaluate the LSV with US (including high frequency evaluation), Doppler, MRI and the contribution of the associated clinical conditions previously known and neurodevelopmental results.

Cranial US was performed by one pediatric radiologist with using 5-8-MHz convex and 7-12-MHz linear transducer (including color Doppler) for four months. LSV was graded by number of branching structures (0: no depiction, 1: 1-2 branches, 2: more than 3 branches) on both frequency images. Associated clinical conditions were evaluated including TORCH infection, chromosomal abnormalities, congenital heart disease (CHD), hypoxic-ischemic events, twin-to-twin transfusion syndrome, neonatal lupus erythematosus, hydrops fetalis, metabolic disorders and diabetic fetopathy. Evaluation of neurodevelopmental delay and/or MRI was performed during the follow-up period.

One hundred ten neonates (M:F 47:63, mean gestational age 36.2±3.7 weeks) included in this study and the mean time of US was 2.5±3.0 weeks after birth. LSV was detected in 29.1% (22 in grade 1 and 10 in grade 2) with convex and 100% (33 in grade 1 and 77 in grade 2) with linear transducer. Doppler flow in the echogenic structure was not defined in only 3 patients who all had CHD (p=0.028). In considering associated clinical conditions, there were 34 CHD, 13 hypoxia, 2 CMV infection, 2 Down syndrome and one SLE. CHD (p=0.011) and absence of Doppler flow (p<0.001) were more common in high grade LSV. LSV did not shown on MRI (n=21). During follow-up (0-483 days; mean 273), five patients showed neurodevelopmental delay and it was more common in high grade LSV (p=0.015).

High grade LSV is more common in patients with CHD and related with neurodevelopmental delay, although brain MR does not show this lesion.

LSV is common finding (29.1%) during cranial US. If there is high grade LSV on cranial US, Doppler study with high frequency linear transducer and cardiac evaluation to rule out CHD is recommended.

Lee, M, Kim, M, Lee, S, Namgung, R, Park, K, Lenticulostriate Vasculopathy on Ultrasonography, Doppler and MRI, with Associated Clinical Conditions and Neurodevelopmental Results.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004790.html