Maria Grazia Capretti1, Marcello Lanari2, Giovanni Tani3, Gina Ancora4, Rita Sciutti3, Concetta Marsico4, Tiziana Lazzarotto5, Liliana Gabrielli5, Brunella Guerra6, Luigi Corvaglia4, Giacomo Faldella4. 1. Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy. Electronic address: mariagrazia.capretti@virgilio.it. 2. Paediatric Department, S. Maria della Scaletta Hospital, Imola, Italy. 3. Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Paediatric Radiology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy. 4. Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy. 5. Department of Haematology, Oncology and Laboratory Medicine, Operative Unit of Microbiology and Virology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy. 6. Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Obstetrics and Gynaecology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
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.
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.
Authors: Raymund R Razonable; Naoki Inoue; Swetha G Pinninti; Suresh B Boppana; Tiziana Lazzarotto; Liliana Gabrielli; Giuliana Simonazzi; Philip E Pellett; D Scott Schmid Journal: J Infect Dis Date: 2020-03-05 Impact factor: 5.226
Authors: Tatiana M Lanzieri; Winnie Chung; Marily Flores; Peggy Blum; A Chantal Caviness; Stephanie R Bialek; Scott D Grosse; Jerry A Miller; Gail Demmler-Harrison Journal: Pediatrics Date: 2017-02-16 Impact factor: 7.124
Authors: Suresh B Boppana; William J Britt; Karen Fowler; S Cecelia Hutto; Scott H James; David W Kimberlin; Claudette Poole; Shannon A Ross; Richard J Whitley Journal: J Infect Dis Date: 2017-12-16 Impact factor: 5.226