<scp>OC</scp>01.04: Periventricular leukomalacia in the fetus: prenatal imaging and diagnostic features
Bibliographic record
Abstract
Cerebral white matter injury, consisting primarily of periventricular leukomalacia (PVL) and periventricular hemorrhagic infarction (PVHI) is well-described in premature infants. However, typical lesions of PVL and PVHI are uncommonly reported during fetal life. Recognition of abnormalities in the intermediate zone and subplate zone could allow the diagnosis of white matter injury during the intrauterine life. The purpose of this study is to identify prenatal imaging features of PVL and PVHI in the fetus and to assess associated risk factors. Institutional ethical approval was obtained to review prenatal sonographic and MRI records to identify fetuses with findings suggestive of PVL and PVHI. Correlation was made with postnatal imaging, clinical, and/or autopsy findings. Fetuses with intrauterine infection were excluded. A total of 38 fetuses were identified by abnormal prenatal neurosonography and/or fetal MRI. Evidence of intracranial hemorrhage was present in 14/38 fetuses. PVHI was identified in 6 fetuses with intraventricular hemorrhage. PVL was present in 24. In 16/24 fetuses, PVL was extensive and diffuse. Complications of monochorionic twinning were present in 6, and hydrops fetalis was present in 6. Eight fetuses had focal PVL, and 3 of these were associated with demise of a monochorionic co-twin. Metabolic disorders and evidence of intracranial hemorrhage were identified in 2 fetuses. Exposure to teratogens known to be associated with brain injury occurred in 2/8 fetuses. Four fetuses had focal periventricular white matter defects; these were associated with severe intraventricular hemorrhage and presentation late in the third trimester. Targeted neurosonography provides high-resolution imaging of the fetal brain and is effective in identifying fetuses with abnormal white matter from a variety of etiological insults. This is primarily accomplished by evaluating abnormalities in transient laminar patterns in the developing white matter of the fetal cerebrum, with or without intracranial hemorrhage.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".