Nehal A Parikh1, Christopher R Pierson2, Jerome A Rusin3. 1. Cincinnati Children's Hospital, The Perinatal Institute, Cincinnati, Ohio; Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio. Electronic address: naparikh7@gmail.com. 2. Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Pathology, Division of Anatomy, The Ohio State University College of Medicine, Columbus, Ohio. 3. Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio.
Abstract
BACKGROUND: Diffuse excessive high signal intensity abnormality is the most common finding on term-equivalent age magnetic resonance imaging in extremely preterm infants. Yet its clinical significance remains a matter of debate, in part because of a lack of prior imaging-pathology correlational studies. PATIENT PRESENTATIONS: We present two 24-week-gestation infants with complicated clinical courses who died at 33 and 46 weeks postmenstrual age with magnetic resonance imaging evidence of diffuse excessive high signal intensity. Two patients with periventricular leukomalacia and two without injury were examined for comparison. Immunohistochemistry characterized the presence of reactive astrocytes, microglia, myelin, and axons. Infants with periventricular leukomalacia demonstrated the typical microscopic necrosis with spheroids, gliosis/microgliosis with reduction in stainable myelin and axons. Infants with diffuse excessive high signal intensity showed vacuolated regions with increased reactive astrocytes and microglia and fewer oligodendroglial cell bodies/processes and dramatic reduction in axon number. CONCLUSION: These two individuals with diffuse excessive high signal intensity exhibited pathologic characteristics that were overlapping but distinct from those of periventricular leukomalacia. Copyright Â
BACKGROUND: Diffuse excessive high signal intensity abnormality is the most common finding on term-equivalent age magnetic resonance imaging in extremely preterm infants. Yet its clinical significance remains a matter of debate, in part because of a lack of prior imaging-pathology correlational studies. PATIENT PRESENTATIONS: We present two 24-week-gestation infants with complicated clinical courses who died at 33 and 46 weeks postmenstrual age with magnetic resonance imaging evidence of diffuse excessive high signal intensity. Two patients with periventricular leukomalacia and two without injury were examined for comparison. Immunohistochemistry characterized the presence of reactive astrocytes, microglia, myelin, and axons. Infants with periventricular leukomalacia demonstrated the typical microscopic necrosis with spheroids, gliosis/microgliosis with reduction in stainable myelin and axons. Infants with diffuse excessive high signal intensity showed vacuolated regions with increased reactive astrocytes and microglia and fewer oligodendroglial cell bodies/processes and dramatic reduction in axon number. CONCLUSION: These two individuals with diffuse excessive high signal intensity exhibited pathologic characteristics that were overlapping but distinct from those of periventricular leukomalacia. Copyright Â
Authors: Venkata Sita Priyanka Illapani; David A Edmondson; Kim M Cecil; Mekibib Altaye; Manoj Kumar; Karen Harpster; Nehal A Parikh Journal: Pediatr Res Date: 2021-03-02 Impact factor: 3.953
Authors: Hailong Li; Nehal A Parikh; Jinghua Wang; Stephanie Merhar; Ming Chen; Milan Parikh; Scott Holland; Lili He Journal: Front Neurosci Date: 2019-06-18 Impact factor: 4.677