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Review
. 2022 May 18;22(1):293.
doi: 10.1186/s12887-022-03334-x.

Pre- and postnatal brain magnetic resonance imaging in congenital cytomegalovirus infection: a case report and a review of the literature

Laurien Vanbuggenhout  1 , Michael Aertsen  2 , Luc De Catte  3 , Gunnar Naulaers  4
Affiliations
Review

Pre- and postnatal brain magnetic resonance imaging in congenital cytomegalovirus infection: a case report and a review of the literature

Laurien Vanbuggenhout et al. BMC Pediatr. .

Abstract

Background: Congenital cytomegalovirus infection (cCMV) is the most common known viral cause of neurodevelopmental delay in children. The risk of severe cerebral abnormalities and neurological sequelae is greatest when the infection occurs during the first trimester of pregnancy. Pre- and postnatal imaging can provide additional information and may help in the prediction of early neurological outcome.

Case presentation: This report presents the case of a newborn with cCMV infection with diffuse parenchymal calcifications, white matter (WM) abnormalities and cerebellar hypoplasia on postnatal brain imaging after magnetic resonance imaging (MRI) and neurosonogram (NSG) at 30 weeks showing lenticulostriate vasculopathy, bilateral temporal cysts and normal gyration pattern according to the gestational age (GA). No calcifications were seen on prenatal imaging.

Conclusion: cCMV infection can still evolve into severe brain damage after 30 weeks of GA. For this reason, a two-weekly follow-up by fetal NSG with a repeat in utero MRI (iuMRI) in the late third trimester is recommended in cases with signs of active infection.

Keywords: Brain; Calcifications; Congenital cytomegalovirus infection; Magnetic resonance imaging; Neurological outcome.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Postnatal cranial ultrasound, convex transducer. a coronal plane at the foramen of Monro. b parasagittal plane over the left ventricle. At day 1 of life lenticulostriate vasculopathy (white arrow), germinolysis (white square) and extensive periventricular calcifications (white circle) were visible
Fig. 2
Fig. 2
Magnetic resonance imaging. a Prenatal T2-weighted echo planar imaging (EPI) in the axial plane b Postnatal susceptibility weighted imaging (SWI) in the axial plane. Postnatally, the bilateral periventricular calcifications (black circle) are seen, not evident on in utero EPI images
Fig. 3
Fig. 3
Postnatal MRI of the brain at day 19. a Apparent diffusion coefficient (ADC) map in the axial plane. b T2-weighted axial image. c T1-weighted axial plane. d T1-weighted sagittal plane. a, b Diffuse white matter signal alterations on T2 weighted images with increased ADC values on diffusion weighted imaging. c, d Extensive bilateral periventricular calcifications in the axial and sagittal plane (circle and square)
Fig. 4
Fig. 4
Neuroradiological findings according to time of infection
See this image and copyright information in PMC

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