D Kotovich1,2, J S B Guedalia3, C Hoffmann4, G Sze5, A Eisenkraft1,2, G Yaniv6,7,5. 1. From The Faculty of Medicine (D.K., A.E.), Institute for Research in Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel. 2. The Israel Defense Forces Medical Corps (D.K., A.E.), Chevy Chase, Maryland. 3. Neuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel. 4. Department of Diagnostic Imaging (C.H.). 5. Department of Radiology and Biomedical Imaging (G.S., G.Y.), Yale School of Medicine, New Haven, Connecticut. 6. Neuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel Gal.yaniv@yale.edu. 7. Dr. Pinchas Bornstein Talpiot Medical Leadership Program (G.Y.), Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
Abstract
BACKGROUND AND PURPOSE: Cytomegalovirus is the leading intrauterine infection. Fetal MR imaging is an accepted tool for fetal brain evaluation, yet it still lacks the ability to accurately predict the extent of the neurodevelopmental impairment, especially in fetal MR imaging scans with unremarkable findings. Our hypothesis was that intrauterine cytomegalovirus infection causes diffusional changes in fetal brains and that those changes may correlate with the severity of neurodevelopmental deficiencies. MATERIALS AND METHODS: A retrospective analysis was performed on 90 fetal MR imaging scans of cytomegalovirus-infected fetuses with unremarkable results and compared with a matched gestational age control group of 68 fetal head MR imaging scans. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes; basal ganglia; thalamus; and pons. For neurocognitive assessment, the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) was used on 58 children in the cytomegalovirus-infected group. RESULTS: ADC values were reduced for the cytomegalovirus-infected fetuses in most brain areas studied. The VABS-II showed no trend for the major domains or the composite score of the VABS-II for the cytomegalovirus-infected children compared with the healthy population distribution. Some subdomains showed an association between ADC values and VABS-II scores. CONCLUSIONS: Cytomegalovirus infection causes diffuse reduction in ADC values in the fetal brain even in unremarkable fetal MR imaging scans. Cytomegalovirus-infected children with unremarkable fetal MR imaging scans do not deviate from the healthy population in the VABS-II neurocognitive assessment. ADC values were not correlated with VABS-II scores. However, the lack of clinical findings, as seen in most cytomegalovirus-infected fetuses, does not eliminate the possibility of future neurodevelopmental pathology.
BACKGROUND AND PURPOSE: Cytomegalovirus is the leading intrauterine infection. Fetal MR imaging is an accepted tool for fetal brain evaluation, yet it still lacks the ability to accurately predict the extent of the neurodevelopmental impairment, especially in fetal MR imaging scans with unremarkable findings. Our hypothesis was that intrauterine cytomegalovirus infection causes diffusional changes in fetal brains and that those changes may correlate with the severity of neurodevelopmental deficiencies. MATERIALS AND METHODS: A retrospective analysis was performed on 90 fetal MR imaging scans of cytomegalovirus-infected fetuses with unremarkable results and compared with a matched gestational age control group of 68 fetal head MR imaging scans. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes; basal ganglia; thalamus; and pons. For neurocognitive assessment, the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) was used on 58 children in the cytomegalovirus-infected group. RESULTS: ADC values were reduced for the cytomegalovirus-infected fetuses in most brain areas studied. The VABS-II showed no trend for the major domains or the composite score of the VABS-II for the cytomegalovirus-infectedchildren compared with the healthy population distribution. Some subdomains showed an association between ADC values and VABS-II scores. CONCLUSIONS:Cytomegalovirus infection causes diffuse reduction in ADC values in the fetal brain even in unremarkable fetal MR imaging scans. Cytomegalovirus-infectedchildren with unremarkable fetal MR imaging scans do not deviate from the healthy population in the VABS-II neurocognitive assessment. ADC values were not correlated with VABS-II scores. However, the lack of clinical findings, as seen in most cytomegalovirus-infected fetuses, does not eliminate the possibility of future neurodevelopmental pathology.
Authors: Serena J Counsell; Joanna M Allsop; Michael C Harrison; David J Larkman; Nigel L Kennea; Olga Kapellou; Frances M Cowan; Joseph V Hajnal; A David Edwards; Mary A Rutherford Journal: Pediatrics Date: 2003-07 Impact factor: 7.124
Authors: S Lipitz; C Hoffmann; B Feldman; M Tepperberg-Dikawa; E Schiff; B Weisz Journal: Ultrasound Obstet Gynecol Date: 2010-04-15 Impact factor: 7.299
Authors: Steven P Miller; Daniel B Vigneron; Roland G Henry; Mary Ann Bohland; Camilla Ceppi-Cozzio; Chen Hoffman; Nancy Newton; J Colin Partridge; Donna M Ferriero; A James Barkovich Journal: J Magn Reson Imaging Date: 2002-12 Impact factor: 4.813
Authors: G Yaniv; C Hoffmann; B Weisz; S Lipitz; E Katorza; D Kidron; D Bergman; A Biegon Journal: Ultrasound Obstet Gynecol Date: 2016-05 Impact factor: 7.299
Authors: Nadja Schönberg; Christian Weisstanner; Roland Wiest; Harald M Bonél; Eike I Piechowiak; Jennifer L Cullmann; Luigi Raio; Manuela Pastore-Wapp; Nedelina Slavova Journal: J Neuroimaging Date: 2020-06-17 Impact factor: 2.486