Prediction of Neurodevelopmental Impairment in Congenital Cytomegalovirus Infection by Early Postnatal Magnetic Resonance Imaging
- 3 June 2020
- journal article
- research article
- Published by S. Karger AG in Neonatology
- Vol. 117 (4), 460-466
- https://doi.org/10.1159/000508218
Abstract
Introduction: Congenital cytomegalovirus infection (CCMVI) may result in neurodevelopmental impairments (NDIs) such as hearing loss, developmental delay, epilepsy, and cerebral palsy. We aimed to investigate the potential for brain magnetic resonance imaging (MRI) to predict NDI in patients with CCMVI. Methods: We studied infants with CCMVI who were referred to our hospital from April 2010 to October 2018 and underwent a brain MRI within 3 months since birth. We screened for 6 classic presentations of CCMVI including ventriculomegaly, periventricular cysts, hippocampal dysplasia, cerebellar hypoplasia, migration disorders, and white matter abnormalities. Images were interpreted by a blinded pediatric radiologist. NDI was defined as having a developmental quotient Results: The study involved 42 infants with CCMVI (median gestational age 38 weeks, birthweight 2,516 g). At least one abnormal finding was detected in 28 (67%) infants. Abnormal findings consisted of 3 cerebellar hypoplasia (7%), 7 migration disorders (17%), 26 white matter abnormalities (62%), 12 periventricular cysts (28%), 1 hippocampal dysplasia (2%), and 20 ventriculomegaly (48%). Abnormal findings were significantly more prevalent in infants with clinical symptoms (21/24, 91%) than in those without (7/19, 37%, p < 0.01). For NDI prediction, having ≥2 of ventriculomegaly, periventricular cysts, and white matter abnormality produced the highest Youden index values (0.78). Conclusion: Infants with CCMVI with at least 2 of the abovementioned specific brain image abnormalities may be at high risk of developing NDI.Keywords
This publication has 26 references indexed in Scilit:
- Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infectionBrain & Development, 2014
- Spectrum of Disease and Outcome in Children with Symptomatic Congenital Cytomegalovirus InfectionThe Journal of Pediatrics, 2014
- Screening for congenital cytomegalovirus infection using newborn urine samples collected on filter paper: feasibility and outcomes from a multicentre studyBMJ Open, 2011
- Disorders of Cortical Formation: MR Imaging FeaturesAmerican Journal of Neuroradiology, 2008
- Clinical findings and adverse outcome in neonates with symptomatic congenital cytomegalovirus (SCCMV) infectionEuropean Journal of Pediatrics, 2006
- Pattern of White Matter Abnormalities at MR Imaging: Use of Polymerase Chain Reaction Testing of Guthrie Cards to Link Pattern with Congenital Cytomegalovirus InfectionRadiology, 2004
- Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn InfantClinical Microbiology Reviews, 2002
- Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infectionThe Journal of Pediatrics, 2001
- Neuroradiographic Findings in the Newborn Period and Long-term Outcome in Children With Symptomatic Congenital Cytomegalovirus InfectionPEDIATRICS, 1997
- Herpesvirus Infections of PregnancyThe New England Journal of Medicine, 1985