Normal Periventricular Halo vs. Periventricular Leukomalacia (PVL) on Ultrasound

A periventricular echogenic halo is a normal developmental variant seen in 97% of premature infants born before 32 weeks of gestation, and can be confused with PVL.

To differentiate this normal halo from the pathological white matter of PVL, radiologists must carefully assess the echogenicity and margins:

• Normal halo is homogeneous, poorly defined, and less echogenic than the choroid plexus.

• Conversely, PVL is inhomogeneous, has distinct lobulated margins, is as echogenic or more echogenic than the choroid plexus, and characteristically evolves into multiseptated cysts after 2 to 3 weeks .