Hiroyuki Kidokoro1, Anna Shiraki2, Yuka Torii2, Masaharu Tanaka2, Hiroyuki Yamamoto2, Hirokazu Kurahashi3, Koichi Maruyama4, Akihisa Okumura3, Jun Natsume2, Yoshinori Ito2. 1. Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan. kidokoro@med.nagoya-u.ac.jp. 2. Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan. 3. Department of Pediatrics, Aichi Medical University, Nagakute, Japan. 4. Division of Pediatric Neurology, Aichi Developmental Disability Center, Kasugai, Japan.
Abstract
PURPOSE: Brain MRI provides important information about suspected congenital CMV infection in neonatally underdiagnosed children. This study aimed to describe MRI findings in children in whom congenital CMV infection was not suspected during the neonatal period and was proven retrospectively. METHODS: We enrolled 31 children referred to the pediatric neurology clinic with neurological symptoms who were proven to have congenital CMV infection based on dried umbilical cord samples. Upon diagnosis, MR and CT images were assessed using the van der Knaap scoring system integrated with additional variables. Two investigators independently assessed all images. RESULTS: The age at diagnosis was < 12 months in 14, 12-24 months in 11, and > 24 months in 6 patients. The initial symptom triggering clinic referral was delayed development in 22, seizure in 5, deafness in 3, and hemiplegia in 1 patient. Of the 31 children, 30 had a white matter (WM) abnormality predominant in the deep WM of the parietal lobe (n = 25). Anterior temporal lesions were observed in 21 children. Cortical lesions were observed in 7 children, suggestive of polymicrogyria. No child had cerebellar or brainstem abnormalities. Brain CT was performed in 22 of 31 children, and 11 showed punctate cerebral calcification in the periventricular and/or deep WM. CONCLUSION: Patients with congenital CMV infection with delayed neurological symptoms show a relatively uniform pattern of parietal-dominant multifocal WM lesions and anterior temporal lesions, with or without polymicrogyria.
PURPOSE: Brain MRI provides important information about suspected congenital CMV infection in neonatally underdiagnosed children. This study aimed to describe MRI findings in children in whom congenital CMV infection was not suspected during the neonatal period and was proven retrospectively. METHODS: We enrolled 31 children referred to the pediatric neurology clinic with neurological symptoms who were proven to have congenital CMV infection based on dried umbilical cord samples. Upon diagnosis, MR and CT images were assessed using the van der Knaap scoring system integrated with additional variables. Two investigators independently assessed all images. RESULTS: The age at diagnosis was < 12 months in 14, 12-24 months in 11, and > 24 months in 6 patients. The initial symptom triggering clinic referral was delayed development in 22, seizure in 5, deafness in 3, and hemiplegia in 1 patient. Of the 31 children, 30 had a white matter (WM) abnormality predominant in the deep WM of the parietal lobe (n = 25). Anterior temporal lesions were observed in 21 children. Cortical lesions were observed in 7 children, suggestive of polymicrogyria. No child had cerebellar or brainstem abnormalities. Brain CT was performed in 22 of 31 children, and 11 showed punctate cerebral calcification in the periventricular and/or deep WM. CONCLUSION:Patients with congenital CMV infection with delayed neurological symptoms show a relatively uniform pattern of parietal-dominant multifocal WM lesions and anterior temporal lesions, with or without polymicrogyria.
Authors: Mieke M Cannie; Roland Devlieger; Mina Leyder; Filip Claus; Astrid Leus; Luc De Catte; Veerle Cossey; Ina Foulon; Elise Van der Valk; Walter Foulon; Teresa Cos; Anja Bernaert; Raymond Oyen; Jacques C Jani Journal: Eur Radiol Date: 2016-03-17 Impact factor: 5.315
Authors: Natanja Oosterom; Joppe Nijman; Julia Gunkel; Tom F W Wolfs; Floris Groenendaal; Malgosia A Verboon-Maciolek; Linda S de Vries Journal: Neonatology Date: 2015-03-10 Impact factor: 4.035
Authors: Shannon A Ross; Amina Ahmed; April L Palmer; Marian G Michaels; Pablo J Sánchez; Audra Stewart; David I Bernstein; Kristina Feja; Karen B Fowler; Suresh B Boppana Journal: J Pediatr Date: 2017-02-22 Impact factor: 4.406