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Published in: Pediatric Radiology 10/2003

01-10-2003 | Original Article

Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases

Authors: Mayass El Ayoubi, Odile de Bethmann, Michèle Monset-Couchard

Published in: Pediatric Radiology | Issue 10/2003

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Abstract

Background

Neonatal branching echogenic streaks in the basal ganglia or 'lenticulostriate vasculopathy' (LSV) has no clear comprehensive aetiology.

Objective

To provide some clinical evidence, possibly relevant to aetiology, by analysis of a large series.

Materials and methods

Seventy cases (9 deaths, 3 post mortem) identified between 1981 and 2000 out of 9,138 neonates with routine brain sonograms (578 in a protocol for neonates from HIV+ mothers). Review of maternal/neonatal charts for clinical data and serologic status. Retrospective analysis of sonograms for grading and time course of LSV and coexistent abnormalities.

Results

LSV was unilateral in 31 cases (22 right), bilateral in 39. Grading separated 8 major, 27 moderate and 35 minor patterns. In 42 cases, LSV was isolated, and in 28 it was mixed with peri-intraventricular haemorrhage grades I or II and/or leucomalacia. LSV was detected in the first postnatal week in 56 instances and appeared later in 13. Disappearance occurred mostly within 2 months. Perinatal circumstances: 13 recipient monochorionic twins (polycythaemia from twin-twin transfusion syndromes), 20 HIV+ mothers (possible immunological disturbances; only 2 infected neonates), 10 congenital anomalies, 1 toxoplasmosis, 1 postnatal cytomegalovirus infection, 25 miscellaneous conditions. Numerous maternal and neonatal factors were non-contributory.

Conclusions

These results do not support congenital toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections as the main causative factor. Polycythaemia and various immunological disturbances may be involved, as well as infectious agents not appropriately screened by routine serodiagnoses.
Literature
1.
go back to reference Rumack CM, Johnson ML (1983) Role of CT and ultrasound in neonatal brain imaging. J Comput Tomog 7:17–29 Rumack CM, Johnson ML (1983) Role of CT and ultrasound in neonatal brain imaging. J Comput Tomog 7:17–29
2.
go back to reference Grant EG, Williams AL, Schellinger D, et al (1985) Intracranial calcification in the infant and neonate: evaluation by sonography and CT. Radiology 157:63–68PubMed Grant EG, Williams AL, Schellinger D, et al (1985) Intracranial calcification in the infant and neonate: evaluation by sonography and CT. Radiology 157:63–68PubMed
3.
go back to reference Teele RL, Hernanz-Schulman M, Sotrel A (1988) Echogenic vasculature in the basal ganglia of neonates: a sonographic sign of vasculopathy. Radiology 169: 423–427PubMed Teele RL, Hernanz-Schulman M, Sotrel A (1988) Echogenic vasculature in the basal ganglia of neonates: a sonographic sign of vasculopathy. Radiology 169: 423–427PubMed
4.
go back to reference Ben-Ami T, Yousefzadeh D, Backus M, et al (1990) Lenticulostriate vasculopathy in infants with infections of the central nervous system: sonographic and Doppler findings. Pediatr Radiol 20:575–579PubMed Ben-Ami T, Yousefzadeh D, Backus M, et al (1990) Lenticulostriate vasculopathy in infants with infections of the central nervous system: sonographic and Doppler findings. Pediatr Radiol 20:575–579PubMed
5.
go back to reference Hughes P, Weinberger E, Shaw DW (1991) Linear areas of echogenicity in the thalami and basal ganglia of neonates: an expanded association. Radiology 179:103–105PubMed Hughes P, Weinberger E, Shaw DW (1991) Linear areas of echogenicity in the thalami and basal ganglia of neonates: an expanded association. Radiology 179:103–105PubMed
6.
go back to reference De Vries LS, Beck FJ, Stoutenbeek P (1995) Lenticulostriate vasculopathy in twin-to-twin transfusion syndrome: sonographic and CT findings. Pediatr Radiol 25: S41-S42PubMed De Vries LS, Beck FJ, Stoutenbeek P (1995) Lenticulostriate vasculopathy in twin-to-twin transfusion syndrome: sonographic and CT findings. Pediatr Radiol 25: S41-S42PubMed
7.
go back to reference Estroff JA, Parad RB, Teele RL, et al (1992) Echogenic vessels in the fetal thalami and basal ganglia associated with cytomegalovirus infection. J Ultrasound Med 11:686–688PubMed Estroff JA, Parad RB, Teele RL, et al (1992) Echogenic vessels in the fetal thalami and basal ganglia associated with cytomegalovirus infection. J Ultrasound Med 11:686–688PubMed
8.
go back to reference Kao S, Abu-Yousef M (2000) Case of the day answers. Diagnosis: mineralizing (lenticulostriate) vasculopathy. J Ultrasound Med 19:362PubMed Kao S, Abu-Yousef M (2000) Case of the day answers. Diagnosis: mineralizing (lenticulostriate) vasculopathy. J Ultrasound Med 19:362PubMed
9.
go back to reference Shefer-Kaufman N, Mimouni FB, Stavorovsky Z, et al (1999) Incidence and clinical significance of echogenic vasculature in the basal ganglia of newborns. Am J Perinatol 16:315–319PubMed Shefer-Kaufman N, Mimouni FB, Stavorovsky Z, et al (1999) Incidence and clinical significance of echogenic vasculature in the basal ganglia of newborns. Am J Perinatol 16:315–319PubMed
10.
go back to reference Monset-Couchard M, de Bethmann O, Brouard-Orzechowski C, et al (1987) Evaluation of peri-intraventricular hemorrhages in newborn infants taking into account laterality and parenchymal location. Application to 323 consecutive cases (in French). J Radiol 68:159–166PubMed Monset-Couchard M, de Bethmann O, Brouard-Orzechowski C, et al (1987) Evaluation of peri-intraventricular hemorrhages in newborn infants taking into account laterality and parenchymal location. Application to 323 consecutive cases (in French). J Radiol 68:159–166PubMed
11.
go back to reference Monset-Couchard M, de Bethmann O, Radvanyi-Bouvet MF, et al (1988) Neurodevelopmental outcome in cystic periventricular leukomalacia (CPVL) (30 cases). Neuropediatrics 19:124–131PubMed Monset-Couchard M, de Bethmann O, Radvanyi-Bouvet MF, et al (1988) Neurodevelopmental outcome in cystic periventricular leukomalacia (CPVL) (30 cases). Neuropediatrics 19:124–131PubMed
12.
go back to reference Mamelle N, Munoz F, Grandjean H (1996) Fetal growth from the AUDIPOG study. I. Establishment of reference curves. J Gynecol Obstet Biol Reprod 25:61–70 Mamelle N, Munoz F, Grandjean H (1996) Fetal growth from the AUDIPOG study. I. Establishment of reference curves. J Gynecol Obstet Biol Reprod 25:61–70
13.
go back to reference Cabanas F, Pellicer A, Morales C, et al (1994) New pattern of hyperechogenicity in thalamus and basal ganglia studied by color Doppler flow imaging. Pediatr Neurol 10:109–116CrossRefPubMed Cabanas F, Pellicer A, Morales C, et al (1994) New pattern of hyperechogenicity in thalamus and basal ganglia studied by color Doppler flow imaging. Pediatr Neurol 10:109–116CrossRefPubMed
14.
go back to reference Chabra S, Kriss VM, Pauly TH, et al (1997) Neurosonographic diagnosis of thalamic/basal ganglia vasculopathy in trisomy 13—an important diagnostic aid. Am J Med Genet 72:291–293CrossRefPubMed Chabra S, Kriss VM, Pauly TH, et al (1997) Neurosonographic diagnosis of thalamic/basal ganglia vasculopathy in trisomy 13—an important diagnostic aid. Am J Med Genet 72:291–293CrossRefPubMed
15.
go back to reference Wang HS, Kuo MF, Chang TC (1995) Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis. AJNR 16:97–102 Wang HS, Kuo MF, Chang TC (1995) Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis. AJNR 16:97–102
16.
go back to reference Coley BD, Rusin JA, Boue DR (2000) Importance of hypoxic/ischemic conditions in the development of cerebral lenticulostriate vasculopathy. Pediatr Radiol 30:846–855CrossRefPubMed Coley BD, Rusin JA, Boue DR (2000) Importance of hypoxic/ischemic conditions in the development of cerebral lenticulostriate vasculopathy. Pediatr Radiol 30:846–855CrossRefPubMed
17.
go back to reference Mercuri E, Rutherford M, Cowan F, et al (1999) Early prognostic indicators of outcome in infants with neonatal cerebral infarction: a clinical, electroencephalogram, and magnetic resonance imaging study. Pediatrics 103:39–46PubMed Mercuri E, Rutherford M, Cowan F, et al (1999) Early prognostic indicators of outcome in infants with neonatal cerebral infarction: a clinical, electroencephalogram, and magnetic resonance imaging study. Pediatrics 103:39–46PubMed
18.
go back to reference Sreenan C, Bhargava R, Robertson CM (2000) Cerebral infarction in the term newborn: clinical presentation and long-term outcome. J Pediatr 137:351–355CrossRefPubMed Sreenan C, Bhargava R, Robertson CM (2000) Cerebral infarction in the term newborn: clinical presentation and long-term outcome. J Pediatr 137:351–355CrossRefPubMed
19.
go back to reference Fekete SM, Monset-Couchard M, Rugolo LS, et al (2002) Cistos subependimarios diagnosticados pelo ultra-som transfontanelar. J Pediatr (Rio J) 78:375–382 Fekete SM, Monset-Couchard M, Rugolo LS, et al (2002) Cistos subependimarios diagnosticados pelo ultra-som transfontanelar. J Pediatr (Rio J) 78:375–382
20.
go back to reference DeCarli C, Civitello LA, Brouwers P, et al (1993) The prevalence of computed tomographic abnormalities of the cerebrum in 100 consecutive children symptomatic with the human immune deficiency virus. Ann Neurol 34:198–205PubMed DeCarli C, Civitello LA, Brouwers P, et al (1993) The prevalence of computed tomographic abnormalities of the cerebrum in 100 consecutive children symptomatic with the human immune deficiency virus. Ann Neurol 34:198–205PubMed
21.
go back to reference Ries M, Deeg K-H, Wˆlfel D, et al (1992) Colour Doppler imaging of intracranial vasculopathy in severe infantile sialidosis. Pediatr Radiol 22:179–181PubMed Ries M, Deeg K-H, Wˆlfel D, et al (1992) Colour Doppler imaging of intracranial vasculopathy in severe infantile sialidosis. Pediatr Radiol 22:179–181PubMed
22.
go back to reference Weber K, Riebel T, Nasir R (1992) Hyperechoic lesions in the basal ganglia: an incidental sonographic finding in neonates and infants. Pediatr Radiol 22:182–186PubMed Weber K, Riebel T, Nasir R (1992) Hyperechoic lesions in the basal ganglia: an incidental sonographic finding in neonates and infants. Pediatr Radiol 22:182–186PubMed
23.
go back to reference Paczko N, Rotta NT, Silva A, et al (2002) Hiperecogenicidade dos vasos talamicos no recem-nascido prematuro. J Pediatr (Rio J) 78:371–374 Paczko N, Rotta NT, Silva A, et al (2002) Hiperecogenicidade dos vasos talamicos no recem-nascido prematuro. J Pediatr (Rio J) 78:371–374
24.
go back to reference Sharer LR, Epstein LG, Sho E-S, et al (1986) Pathologic features of AIDS encephalopathy in children: evidence for LAV/HTLV III infection of brain. Hum Pathol 17:271–284PubMed Sharer LR, Epstein LG, Sho E-S, et al (1986) Pathologic features of AIDS encephalopathy in children: evidence for LAV/HTLV III infection of brain. Hum Pathol 17:271–284PubMed
25.
go back to reference Belman AL, Lantos G, Horoupian D, et al (1986) AIDS: calcification of the basal ganglia in infants and children. Neurology 36:1192–1199PubMed Belman AL, Lantos G, Horoupian D, et al (1986) AIDS: calcification of the basal ganglia in infants and children. Neurology 36:1192–1199PubMed
26.
go back to reference Sica GT, Norton KI (1990) Intracranial human immunodeficiency virus infection in an infant: sonographic findings. Pediatr Radiol 21:64–65PubMed Sica GT, Norton KI (1990) Intracranial human immunodeficiency virus infection in an infant: sonographic findings. Pediatr Radiol 21:64–65PubMed
27.
go back to reference Bode H, Rudin C (1995) Calcifying arteriopathy in the basal ganglia in human immunodeficiency virus infection. Pediatr Radiol 25:72–73PubMed Bode H, Rudin C (1995) Calcifying arteriopathy in the basal ganglia in human immunodeficiency virus infection. Pediatr Radiol 25:72–73PubMed
Metadata
Title
Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases
Authors
Mayass El Ayoubi
Odile de Bethmann
Michèle Monset-Couchard
Publication date
01-10-2003
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 10/2003
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-003-0948-z

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