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Congenital cytomegalovirus infection: contribution and best timing of prenatal MR imaging

  • Magnetic Resonance
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Abstract

Objective

To predict sensorineural hearing loss (SNHL) and neurological impairment in congenital cytomegalovirus (cCMV) infection using MR imaging and define the best timing in pregnancy for prenatal assessment.

Methods

In 121 patients with confirmed cCMV infection, brain features at MR imaging were respectively graded from 1 to 5: normal; isolated frontal/parieto–occipital hyperintensity; temporal periventricular hyperintensity; temporal/occipital cysts and/or intraventricular septa; migration disorders. Grading was correlated with postnatal SNHL and neurological impairment using regression analysis. In 51 fetuses with MR examinations at 26.9 and 33.0 weeks, the predictive value of SNHL and neurological impairment was compared using ROC curves.

Results

Postnatal follow-up showed SNHL in 18 infants and neurological impairment in 10. MR grading was predictive of SNHL and of neurological impairment (P < 0.001). In grade 1 or 2, none had SNHL and 1/74 had neurological impairment. The areas under ROC curves for prediction of postnatal SNHL and of neurological impairment from first and second MR examination were comparable.

Conclusion

Our data suggest that in cCMV infection, prediction of SNHL and neurological impairment is feasible by fetal MR imaging with a high negative predictive value and can equally be done at 27 or 33 weeks of gestation.

Key points

• In cCMV, isolated periventricular T2-weighted signal hyperintensity has a good postnatal prognosis.

• In cCMV, SNHL and neurological impairment can be predicted at 27 or 33 weeks.

• In cCMV, fetal MR has a high NPV in predicting SNHL.

• In cCMV, fetal MR has a high NPV in predicting neurological impairment.

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Acknowledgments

The scientific guarantor of this publication is Prof Jacques Jani. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Fetal Medicine Foundation Belgium. Lei Ding kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was waived by the Institutional Review Board.

Some study subjects or cohorts have been previously reported in: Foulon I, Naessens A, Foulon W, Casteels A, Gordts F (2008) Hearing loss in children with congenital cytomegalovirus infection in relation to the maternal trimester in which the maternal primary infection occurred. Pediatrics 122:e1123-1127 and Foulon I, Naessens A, Faron G, Foulon W, Jansen AC, Gordts F (2012) Hearing thresholds in children with a congenital CMV infection: a prospective study. Int J Pediatr Otorhinolaryngol 76:712-717. Methodology: retrospective, prognostic study/observational, multicentre study.

Author information

Author notes

  1. Filip Claus

    Present address: Department of Radiology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium

Authors and Affiliations

  1. Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    Mieke M. Cannie

  2. Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Fetal Medicine Unit, Place A. Van Gehuchten 4, 1020, Brussels, Belgium

    Teresa Cos & Jacques C. Jani

  3. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium

    Roland Devlieger, Luc De Catte & Elise Van der valk

  4. Department of Radiology, University Hospitals Leuven, Leuven, Belgium

    Filip Claus & Raymond Oyen

  5. Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium

    Veerle Cossey

  6. Department of Obstetrics, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium

    Mina Leyder & Walter Foulon

  7. Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium

    Mieke M. Cannie & Astrid Leus

  8. Department of Otolaryngology - Head and Neck Surgery, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium

    Ina Foulon

  9. Department of Radiology, Sint-Augustinus Hospital, Antwerp, Belgium

    Anja Bernaert

Authors
  1. Mieke M. Cannie
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Corresponding author

Correspondence to Jacques C. Jani.

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Cannie, M.M., Devlieger, R., Leyder, M. et al. Congenital cytomegalovirus infection: contribution and best timing of prenatal MR imaging. Eur Radiol 26, 3760–3769 (2016). https://doi.org/10.1007/s00330-015-4187-0

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  • DOI: https://doi.org/10.1007/s00330-015-4187-0

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