Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Gent, Belgium.
Department of Neonatology, Ghent University Hospital, C. Heymanslaan 10, 9000, Gent, Belgium.
Eur Radiol. 2021 Oct;31(10):8001-8010. doi: 10.1007/s00330-021-07776-2. Epub 2021 Mar 31.
To investigate the spectrum and frequency of abnormalities on brain MRI in a large cohort of live newborns with congenital CMV (cCMV) infection.
Institutional review board approval and informed consent for neonatal MRI and data collection were obtained. Between January 2010 and January 2018, brain MRI was performed in 196 live newborns diagnosed with cCMV. Images were independently reviewed by 2 pediatric radiologists, blinded to clinical data.
cCMV infection was clinically symptomatic in 26/191 newborns (13.6%). Brain MRI showed abnormalities in 76/196 patients (38.8%). MRI was abnormal in 20/26 clinically symptomatic patients (76.9%): 76.9% showed white matter lesions, 61.5% subependymal cysts, 46.2% ventriculomegaly, 26.9% ventricular adhesions, 26.9% gyral abnormalities, 24.0% calcifications, 15.4% cerebellar anomalies. MRI was abnormal in 55/165 (33.3%) clinically asymptomatic patients: 30.9% had white matter lesions, 15.8% subependymal cysts, 4.2% ventriculomegaly, 2.4% ventricular adhesions, 1.2% gyral abnormalities, 0.6% calcifications, none had cerebellar anomalies. Concomitant brain lesions were seen in all patients with gyral abnormalities, cerebellar anomalies, and calcifications and nearly all patients with subependymal cysts and ventriculomegaly. In all but 4 patients with other detected brain lesions, white matter abnormalities were simultaneously present. In 33/74 patients (45.2%), white matter lesions were seen as a sole abnormality.
White matter lesions were the most common detected abnormality on brain MRI in newborns with congenital CMV. Since brain abnormalities were seen in more than 30% of clinically asymptomatic and 75% of clinically symptomatic newborns, MRI should be advised in all newborns diagnosed with cCMV.
• Neonatal brain MRI showed abnormalities in more than 30% of clinically asymptomatic and 75% of symptomatic newborns with congenital cytomegalovirus infection. • White matter lesions were by far the most common detected abnormality, followed by subependymal cysts and ventricular dilatation. • Lesions in cCMV were often multiple, with many patients showing concomitant lesions.
研究先天性巨细胞病毒（cCMV）感染的大量活产新生儿脑 MRI 异常的频谱和频率。
获得机构审查委员会对新生儿 MRI 和数据收集的批准和知情同意。2010 年 1 月至 2018 年 1 月期间，对 196 例诊断为 cCMV 的活产新生儿进行了脑 MRI 检查。图像由 2 位儿科放射科医生独立审查，对临床数据不知情。
cCMV 感染在 26/191 名新生儿（13.6%）中表现为临床症状。196 例患者中 76 例（38.8%）脑 MRI 异常。26 例临床症状患者中有 20 例（76.9%）MRI 异常：76.9%有白质病变，61.5%有室管膜下囊肿，46.2%有脑室扩大，26.9%有脑室粘连，26.9%有脑回异常，24.0%有钙化，15.4%有小脑异常。165 例临床无症状患者中有 55 例（33.3%）MRI 异常：30.9%有白质病变，15.8%有室管膜下囊肿，4.2%有脑室扩大，2.4%有脑室粘连，1.2%有脑回异常，0.6%有钙化，无一例有小脑异常。所有脑回异常、小脑异常和钙化患者均有伴发脑损伤，几乎所有室管膜下囊肿和脑室扩大患者也有伴发脑损伤。除 4 例其他脑损伤患者外，其余患者均同时存在白质异常。74 例患者中 33 例（45.2%）仅见白质病变。
先天性巨细胞病毒感染新生儿脑 MRI 最常见的异常是白质病变。由于脑异常在 30%以上的临床无症状和 75%的临床有症状新生儿中均可见，因此所有诊断为 cCMV 的新生儿均应建议进行 MRI。
新生儿脑 MRI 显示，先天性巨细胞病毒感染的无症状和有症状新生儿中，超过 30%存在脑异常。
白质病变是迄今为止最常见的异常，其次是室管膜下囊肿和脑室扩张。
cCMV 的病变常常是多灶性的，许多患者伴有并发病变。
