Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection.
OBJECTIVE
To evaluate whether fetal brain magnetic resonance imaging (MRI) adds useful information to the one obtained by ultrasound in fetuses with cytomegalovirus (CMV) infection.


METHODS
MRI and ultrasonographic findings were analyzed retrospectively in 38 fetuses with proven congenital CMV infection. Both techniques were performed on the same week at a mean gestational age of 33 weeks (24-37). The referral indications were maternal seroconversion (n = 19), and ultrasound findings (n = 19). The results were compared with the fetopathologic examination in cases with fetal death or termination of pregnancy (TOP) or the infant's neurological examination.


RESULTS
The 38 cases were classified into three groups, depending on ultrasound findings at referral. Group 1: no ultrasound features (n = 11); group 2: extracerebral features without cerebral abnormalities at ultrasound (n = 13); group 3: presence of cerebral features at ultrasound (n = 14). In group 1, MRI was always normal. In group 2, MRI revealed cerebral features in six cases (46%). In group 3, MRI always confirmed the lesions seen at ultrasound and highlighted other cerebral features.


CONCLUSIONS
MRI can provide important additional information with regard to abnormal gyration, cerebellar hypoplasia, or abnormal signal in white matter. It is certainly useful in the assessment of fetuses with extracerebral features without brain abnormalities detected with ultrasounds. If the fetal ultrasound is strictly normal in an infected fetus, MRI may not detect brain anomalies; however, it seems difficult to not perform this noninvasive procedure.
Maternité, Hôpital Necker Enfants Malades, AP-HP, Université René Descartes. 149 rue de Sèvres, 75015 Paris, France. olivier.picone@abc.aphp.fr
Olivier
O
Picone
Isabelle
I
Simon
Alexandra
A
Benachi
Francis
F
Brunelle
Pascale
P
Sonigo
D054022:Cerebrum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis* / Q000196:embryology; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal