Matsuo Kiyomi, Morioka Ichiro, Oda Mai, Kobayashi Yoko, Nakamachi Yuji, Kawano Seiji, Nagasaka Miwako, Koda Tsubasa, Yokota Tomoyuki, Morikawa Satoru, Miwa Akihiro, Shibata Akio, Minematsu Toshio, Inoue Naoki, Yamada Hideto, Iijima Kazumoto
Department of Pediatrics, Kobe University Hospital, Kobe, Japan.
Department of Pediatrics, Kobe University Hospital, Kobe, Japan.
Brain Dev. 2014 Jan;36(1):10-5. doi: 10.1016/j.braindev.2012.12.009. Epub 2013 Jan 11.
Infants with congenital cytomegalovirus infection (CCMVI) may develop brain abnormalities such as ventricular dilatation, which may potentially associate with sensorineural hearing loss. There is currently no recognized method for quantitative evaluation of ventricle size in infants with CCMVI. Our objectives were to establish a method for quantitative evaluation of ventricle size using computed tomography (CT) in infants with CCMVI, and determine a cut-off value associated with abnormal auditory brainstem response (ABR) early in life.
DESIGN/SUBJECTS: This study enrolled 19 infants with CCMVI and 21 non-infected newborn infants as a control group. Infants with CCMVI were divided into two subgroups according to ABR at the time of initial examination: normal ABR (11 infants) or abnormal ABR (8 infants). Ventricle size was assessed by calculating Evans' index (EI) and lateral ventricle width/hemispheric width (LVW/HW) ratio on brain CT images, and was compared among groups. A cut-off ventricle size associated with abnormal ABR was determined.
EI and LVW/HW ratio were significantly higher in the CCMVI with abnormal ABR group than the control and CCMVI with normal ABR groups. Cut-off values of 0.26 for EI and 0.28 for LVW/HW ratio had a sensitivity of 100% and 100%, respectively, and a specificity of 73% and 91%, respectively, for association with abnormal ABR.
We established a method for quantitative evaluation of ventricle size using EI and LVW/HW ratio on brain CT images in infants with CCMVI. LVW/HW ratio had a more association with abnormal ABR in the early postnatal period than EI.
先天性巨细胞病毒感染（CCMVI）的婴儿可能会出现脑异常，如脑室扩张，这可能与感音神经性听力损失有关。目前尚无公认的方法可对CCMVI婴儿的脑室大小进行定量评估。我们的目标是建立一种使用计算机断层扫描（CT）对CCMVI婴儿的脑室大小进行定量评估的方法，并确定与生命早期异常听觉脑干反应（ABR）相关的临界值。
设计/研究对象：本研究纳入了19例CCMVI婴儿和21例未感染的新生儿作为对照组。CCMVI婴儿在初次检查时根据ABR分为两个亚组：ABR正常（11例婴儿）或ABR异常（8例婴儿）。通过计算脑CT图像上的埃文斯指数（EI）和侧脑室宽度/半球宽度（LVW/HW）比值来评估脑室大小，并在各组之间进行比较。确定与异常ABR相关的临界脑室大小。
ABR异常的CCMVI组的EI和LVW/HW比值显著高于对照组和ABR正常的CCMVI组。EI的临界值为0.26，LVW/HW比值的临界值为0.28，与异常ABR相关的敏感性分别为100%和100%，特异性分别为73%和91%。
我们建立了一种使用EI和LVW/HW比值在CCMVI婴儿的脑CT图像上对脑室大小进行定量评估的方法。在出生后早期，LVW/HW比值比EI与异常ABR的相关性更强。
