Subependymal hemorrhage (SEH) into germinal matrix

Subependymal hemorrhage or germinal matrix hemorrhage occurs in premature infants with very low birth weight (<1500g). The germinal matrix in the immature brain is located around the lateral ventricles and it contains a fine network of fragile blood vessels, which are sensitive to ischemia and changes in perfusion pressure. Subependymal hemorrhage in premature neonates can be easily assessed by ultrasound and be divided into four grades.

Grade Description
Grade I hemorrhage confined to the germinal matrix
Grade II intraventricular hemorrhage (hemocephalus) without ventricular dilation
Grade III intraventricular hemorrhage (hemocephalus) with ventricular dilation
Grade IV intraventricular rupture with hemorrhage into the surrounding white matter


1. Bowerman R, Donn S, Silver T, Jaffe M. Natural history of neonatal periventricular/intraventricular hemorrhage and its complications: sonographic observations. American Journal of Roentgenology. 1984 Nov 1;143(5):1041–52.
2. Radack DM, Baumgart S, Gross GW. Subependymal (grade 1) intracranial hemorrhage in neonates on extracorporeal membrane oxygenation. Frequency and patterns of evolution. Clin Pediatr (Phila). 1994 Oct;33(10):583–7.

3. Smith WL, McGuinness G, Cavanaugh D, Courtney S. Ultrasound screening of premature infants: longitudinal follow-up of intracranial hemorrhage. Radiology. 1983 May 1;147(2):445–8.

Prostatic cancer - types of invasion into seminal vesicles

Researches at the Baylor College of Medicine identified and defined three types of invasion of prostatic cancer into seminal vesicles.

Type Description
Type I direct spread of prostate cancer along the ejaculatory duct complex into the seminal vesicles
Type II invasion through the prostatic capsule into the seminal vesicles
  • Type IIA: direct spread of prostate cancer through the base of the prostate

Germinal matrix hemorrhage - grading of intracranial bleeding in neonates

Grading of intracranial hemorrhage in neonates is based on ultrasound imaging. It has four grades with increasing mortality and decreasing outcome.

Grade Description
Grade I hemorrhage is confined to the germinal matrix
Grade II intraventricular hemorrhage without ventricular dilation
Grade III intraventricular hemorrhage with ventricular dilation
Grade IV

Estimate of stenosis of artery by flow velocity in peripheral arterial occlusive disease

Severity of a stenosis can be estimated by measuring of peak systolic velocity (PSV) in the stenosis and proximal to it and by the appearance of the waveform.

Luminal narrowing PSV stenosis / PSV proximal Description
0 - 49% <2 triphasic waveform, spectral broadening, increased enddiastolic flow velocity in stenosis close to 49%
50 - 74% ≥2

Hydronephrosis in Infants - SFU grading - Society of Fetal Urology

Hydronephrosis in infants is divided into five grades that were standardized by the Society of Fetal Urology. The grading is usually based on ultrasound, ev. intravenous urography.

Grade Description
Grade 0 no splitting of renal sinus
Grade I urine visible in renal pelvis only
Grade II urine fills intrarenal pelvis, extrarenal pelvis, major calyces are dilated

Hydronephrosis - grading of dilatation of hydronephrosis

Hydronephrosis is commonly divided into four grades according to dilation of the pelvicalyceal system and cortical thinning that can be visualised on ultrasound, CT and MRI.

Grade Description
Grade I dilation of the renal pelvis without dilatation of the calices
Grade II dilation of the renal pevis and calices, that become convex; no signs of cortical thinning
Grade III

Grading of injury of the collateral ligament of the knee on MRI and ultrasound

Injuries to the medial collateral injury are divided into three grades similarly to other ligamentous lesions elsewhere.

Grade Description Description - MRI Description - US
Grade I microscopic tear or strain injury edema superficial to the ligament hypoechoic fluid parallel to the ligament
Grade II partial tear

Doubling time - calculation of growth rate of a lesion or a mass

Calculating doubling time of focal lesions or massess can give a hint, whether it has a malignant or rather benign growth dynamics. Doubling time of malignant lesions is between 30 and 500 days with a median of 100 days.

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