Abstract
This study was performed to assess the predictive value of ultrasonography and electroencephalography
(EEG) in order to identify infants with periventricular leukomalacia (PVL) during
the early neonatal period, especially non-cystic cases, and to clarify the combination
of ultrasonographic and EEG findings that are the most useful. We studied 288 eligible
infants, whose gestational ages ranged between 27 and 32 weeks. PVL was observed in
49 infants (26 cystic PVL and 23 non-cystic PVL). On ultrasonography, 31 infants with
PVL were detected on the basis of definite periventricular echodensity (PVE). Thirty-seven
infants had at least one of equivocal or definite PVE or cystic changes, but the other
12 did not have any of them. The sensitivity and specificity were 0.76 and 0.81, respectively.
In EEG findings, acute stage abnormalities (ASA) of grade II or more were recognized
in 31 infants with PVL. The sensitivity and specificity were 0.63 and 0.91, respectively.
Equivocal or definite chronic stage abnormalities (CSA) were seen in 43 infants, the
sensitivity and specificity being 0.88 and 0.84. The sensitivity of CSA was higher
than that of ASA, and the specificity of ASA was higher than that of CSA. When these
EEG findings were combined, 45 infants with PVL were detected. The sensitivity, specificity,
positive predictive value, and negative predictive value were 0.92, 0.77, 0.45, and
0.98, respectively. Moreover, ultrasonographic and EEG findings were combined, 46
out of the 49 infants with PVL were detected with a sensitivity of 0.94 and a specificity
of 0.64. The results indicated that EEG may be suitable for detecting infants at risk
for development of PVL on the basis of its high sensitivity, and ultrasonography may
be useful for confirming the presence of PVL on the grounds of its high specificity.
Appropriate use of these measurements will make an early diagnosis of infants with
PVL possible, even in non-cystic cases.
Keywords
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Article info
Publication history
Accepted:
May 7,
2002
Received in revised form:
April 23,
2002
Received:
October 12,
2001
Identification
Copyright
© 2002 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
