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Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

Journal of Perinatology volume 26, pages 230–236 (2006)Cite this article

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.

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Acknowledgements

Preliminary results were presented at the following meetings: Mead Johnson Nutritionals Greater NY Conference on Perinatal Research, White Plains, NY, 13 October 2000; Annual Meeting of the Eastern Society for Pediatric Research Absecon, NJ, 18 March 2001; NY Perinatal Society, New York, NY, 22 May 2001 and 20 May 2003; 25th Greater NY Conference on Perinatal Research, Tarrytown, NY, 19 November 2003; Annual Meeting of the Eastern Society for Pediatric Research, Old Greenwich, CT, 27 March 2004; and Annual meeting of the American Academy of Pediatrics, San Francisco, CA, 9 October 2004. We wish to thank the parents who have agreed for their infants to participate in the study, Dr Deborah E Campbell for her help and support, Dr Solomon Moshé for reviewing the manuscript, and the whole NICU staff.

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Author notes

  1. L M Soghier

    Present address: Children's Hospital of Philadelphia, Philadelphia, PA, USA

  2. K Aref

    Present address: Practicing Pediatrics in Edmundston, New Brunswick, Canada

Authors and Affiliations

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

    L M Soghier, M Vega, K Aref, G T Reinersman & L P Brion

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

    M Koenigsberg, M Kogan, J Bello, J Romano & T Hoffman

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  1. L M Soghier
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Correspondence to L P Brion.

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Soghier, L., Vega, M., Aref, K. et al. Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants. J Perinatol 26, 230–236 (2006). https://doi.org/10.1038/sj.jp.7211460

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