1. Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection
- Author
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Giovanni Tani, Liliana Gabrielli, Maria Grazia Capretti, Gina Ancora, Tiziana Lazzarotto, Rita Sciutti, Concetta Marsico, Luigi Corvaglia, Brunella Guerra, Marcello Lanari, Giacomo Faldella, Capretti MG, Lanari M, Tani G, Ancora G, Sciutti R, Marsico C, Lazzarotto T, Gabrielli L, Guerra B, Corvaglia L, and Faldella G.
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Pathology ,Sensitivity and Specificity ,Temporal lobe ,White matter ,magnetic resonance ,ultrasound imaging ,Neonatal Screening ,Developmental Neuroscience ,newborn ,Pregnancy ,medicine ,Polymicrogyria ,Humans ,Longitudinal Studies ,Prospective Studies ,Pregnancy Complications, Infectious ,Brain Diseases ,medicine.diagnostic_test ,business.industry ,Hearing Tests ,Infant, Newborn ,Brain ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,congenital cytomegaloviru ,Prognosis ,Echoencephalography ,Magnetic Resonance Imaging ,Hyperintensity ,medicine.anatomical_structure ,Early Diagnosis ,Pediatrics, Perinatology and Child Health ,Cytomegalovirus Infections ,Sensorineural hearing loss ,Female ,Neurology (clinical) ,Cerebellar hypoplasia (non-human) ,business ,Ventriculomegaly ,Follow-Up Studies - Abstract
Purpose: To assess the diagnostic and prognostic value of cerebral magnetic resonance imaging (cMRI) in comparison with that of cerebral ultrasound (cUS) in predicting neurodevelopmental outcome in newborns with congenital cytomegalovirus (CMV) infection. Methods: Forty CMV-congenitally infected newborns underwent cUS and cMRI within the first month of life. Clinical course, laboratory findings, visual/hearing function and neurodevelopmental outcome were documented. Results: Thirty newborns showed normal cMRI, cUS and hearing/visual function in the first month of life; none showed CMV-related abnormalities at follow-up. Six newborns showed pathological cMRI and cUS findings (pseudocystis, ventriculomegaly, calcifications, cerebellar hypoplasia) but cMRI provided additional information (white matter abnormalities in three cases, lissencephaly/polymicrogyria in one and a cyst of the temporal lobe in another one); cerebral calcifications were detected in 3/6 infants by cUS but only in 2/6 by cMRI. Four of these 6 infants showed severe neurodevelopmental impairment and five showed deafness during follow-up. Three newborns had a normal cUS, but cMRI documented white matter abnormalities and in one case also cerebellar hypoplasia; all showed neurodevelopmental impairment and two were deaf at follow-up. One more newborn showed normal cUS and cMRI, but brainstem auditory evoked responses were abnormal; psychomotor development was normal at follow-up. Conclusions: Compared with cUS, cMRI disclosed additional pathological findings in CMV-congenitally infected newborns. cUS is a readily available screening tool useful in the identification of infected newborns with major cerebral involvement. Further studies with a larger sample size are needed to determine the prognostic role of MRI, particularly regarding isolated white matter lesions.
- Published
- 2012