Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection

被引:65
作者
Manara, Renzo [1 ]
Balao, Laura
Baracchini, Claudio [3 ]
Drigo, Paola
D'Elia, Ruggiero [2 ]
Ruga, Ezia Maria [2 ]
机构
[1] Univ Hosp Padua, Neuroradiol Unit, I-35128 Padua, Italy
[2] Univ Padua, Dept Pediat, Div Pediat Infect Dis, Padua, Italy
[3] Univ Padua, Dept Neurol Sci, Padua, Italy
关键词
Brain; Magnetic resonance; CMV; Congenital; Infection; ABNORMALITIES; ULTRASOUND; CHILDREN; PATTERN; LESIONS;
D O I
10.1007/s00247-011-2120-5
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Congenital cytomegalovirus (CMV) infection can lead to severe neurological sequelae, but a defined brain magnetic resonance (MR) pattern and MR predictors of clinical outcome are still lacking. Clinical and MR findings of 14 children with symptomatic congenital CMV infection were retrospectively reviewed. Microcephaly, cerebral palsy and epilepsy were found in eight, six and seven patients, respectively (all concomitant in 6); 12 children developed sensory-neural hearing loss (SNHL). At first MRI (mean age 21 months, range 5-54 months), white matter (WM) involvement was not assessable in two children due to incomplete myelination. WM abnormalities were common (11/12 patients); deep WM was predominantly involved in 5/11; the largest WM lesion was in the parietal lobe in 6/11. Anterior temporal lobe abnormalities were found in 13/14. Six children underwent MRI examination after 2 years of life; in this subgroup, WM abnormalities were extensive and confluent (4/6), bilateral and multifocal (1/6) or absent (1/6). Four children showed a progression of myelination. Ventriculomegaly (9/14), migration disorders (6/14 polymicrogyria and 1/14 pachygyria-lissencephaly) and hippocampal dysplasia (6/14) correlated with severe neurological sequelae (p < 0.05, Fisher exact test), while the presence of WM abnormalities (11/12), periventricular cysts (6/14) and cerebellar hypoplasia (4/14) did not predict the outcome. The spectrum of brain MR abnormalities in symptomatic congenital CMV infection is extremely wide. WM involvement is variable, difficult to evaluate at a very young age and unrelated to clinical outcome, while cortical malformations, ventriculomegaly and hippocampal dysplasia seem to be strong predictors of poor outcome except for SNHL.
引用
收藏
页码:962 / 970
页数:9
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