Research on the diagnosis of Periventricular Leukomalacia (PVL) by ECHO second harmonic imaging in preterm infants

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Most important issue in current neonatal medicine is the prevention of neurological complication especially cerebral palsy, mental retardation and learning disorders. However, it is well known that 5 to 15 % of preterm infants born under 32 weeks of gestation develop neurological complication and 80 % of cerebral palsy is recognized as the result of PVL. According to the surveillance analysis all over the Japan, the incidence of PVL does not change for many years in this country.Second harmonics imaging technique by ECHO which we are presently trying to widely use in the neonatal clinical is simple, bed-side operating, and sensitive for the detection of fine capillary blood flow. This technique has been used in liver and heart blood flow detection together with the usage in adult neurology field.We have succeeded in the detection of blood flow in all cased performed by this Second harmonic imaging technique. Examination time was extremely short compared to MRI and CT. It was safe enough to perform it at the bed side and did not require to move the patient nor to give the sedatives to the patient.PVL patient with LCD (Late onset cardiac dysfunction) episode had severer neurological outcome from the MRI findings. In sepsis, there is a close correlation between oxidative stress and inflammatory or anti-inflammatorycytokines.