The Echogenic Ependymal Wall in Intraventricular Hemorrhage: Sonographic-pathologic Correlation

Fifty-one patients with ultrasound diagnosis of intraventricular hemorrhage (Grades III and IV) were studied retrospectively for the presence of ependymal echogenicity. The sonographic findings were then correlated with histologic findings in six autopsy cases. Forty-one out of fifty-one newborns with intraventricular hemorrhage developed ependymal echogenicity on serial ultrasound studies. This echogenicity appeared approximately seven days after the hemorrhagic event and usually disappeared in about six weeks. Histologic examination revealed disruptions in the ependyma with proliferation and extension of subependymal glial cells onto the ventricular surface in those cases in which ependymal echogenicity was present at the time of death. This layer of proliferating subependymal glial cells may account for the ependymal echogenicity.