Full-term 9 day old male, evaluate for calcifications or masses, patient demonstrated encephalomalacia on ultrasound. There are multifocal areas of cystic encephalomalacia, predominantly involving the left temporal and frontal lobes. Margins of these cavities demonstrate T1 hyperintensity and diffusion restriction, and internal to the cavities are shriveled gyriform tissue with similar signal characteristics. Additionally, small areas of signal change and encephalomalacia are also noted in the right hemisphere. There is an area of encephalomalacia adjacent to the lateral portion of the right lateral ventricular body resulting in volume loss of the corona radiata. No parenchymal edema is seen. No mass effect or midline shift is present. Scattered foci of susceptibility artifact are noted adjacent to the cavities and also throughout the remainder of the parenchyma. The pattern of myelination appears to be somewhat delayed in the right supratentorial hemisphere. In particular, the mild of the perirolandic gyri, the posterior limb of the internal capsule and the ventrolateral nucleus of the right thalamus is not well visualized. The orbits, skull, and scalp soft tissues are unremarkable.
1. Large areas of parenchymal injury and tissue loss, predominantly involving the left frontal and temporal lobes are noted. There is diffusion restricting and T1 hyperintense tissue within and around these cavities, favored to represent mineralization of the injured parenchyma, though some superimposed blood product may be present as well. Please note that CT would provide confirmation of parenchymal calcifications if clinically warranted. These findings are suggestive of a prenatal infection with or without some component of ischemic injury.2. Somewhat delayed pattern of myelination in the right supratentorial hemisphere, particularly affecting the peri-rolandic area gyrus, the posterior limb of the internal capsule, and the ventrolateral nucleus of the right thalamus.