title: Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection.
abstract: OBJECTIVE
  To assess the diagnostic and prognostic value of cerebral magnetic resonance imaging (cMRI) in comparison with that of cerebral ultrasound (cUS) in predicting neurodevelopmental outcome in newborns with congenital cytomegalovirus (CMV) infection.
  
  
  METHODS
  Forty CMV-congenitally infected newborns underwent cUS and cMRI within the first month of life. Clinical course, laboratory findings, visual/hearing function and neurodevelopmental outcome were documented.
  
  
  RESULTS
  Thirty newborns showed normal cMRI, cUS and hearing/visual function in the first month of life; none showed CMV-related abnormalities at follow-up. Six newborns showed pathological cMRI and cUS findings (pseudocystis, ventriculomegaly, calcifications, cerebellar hypoplasia) but cMRI provided additional information (white matter abnormalities in three cases, lissencephaly/polymicrogyria in one and a cyst of the temporal lobe in another one); cerebral calcifications were detected in 3/6 infants by cUS but only in 2/6 by cMRI. Four of these 6 infants showed severe neurodevelopmental impairment and five showed deafness during follow-up. Three newborns had a normal cUS, but cMRI documented white matter abnormalities and in one case also cerebellar hypoplasia; all showed neurodevelopmental impairment and two were deaf at follow-up. One more newborn showed normal cUS and cMRI, but brainstem auditory evoked responses were abnormal; psychomotor development was normal at follow-up.
  
  
  CONCLUSIONS
  Compared with cUS, cMRI disclosed additional pathological findings in CMV-congenitally infected newborns. cUS is a readily available screening tool useful in the identification of infected newborns with major cerebral involvement. Further studies with a larger sample size are needed to determine the prognostic role of MRI, particularly regarding isolated white matter lesions.
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy. Electronic address: mariagrazia.capretti@virgilio.it.
authors: Maria Grazia
authors: MG
authors: Capretti
authors: Paediatric Department, S. Maria della Scaletta Hospital, Imola, Italy.
authors: Marcello
authors: M
authors: Lanari
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Paediatric Radiology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Giovanni
authors: G
authors: Tani
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Gina
authors: G
authors: Ancora
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Paediatric Radiology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Rita
authors: R
authors: Sciutti
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Concetta
authors: C
authors: Marsico
authors: Department of Haematology, Oncology and Laboratory Medicine, Operative Unit of Microbiology and Virology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Tiziana
authors: T
authors: Lazzarotto
authors: Department of Haematology, Oncology and Laboratory Medicine, Operative Unit of Microbiology and Virology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Liliana
authors: L
authors: Gabrielli
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Obstetrics and Gynaecology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Brunella
authors: B
authors: Guerra
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Luigi
authors: L
authors: Corvaglia
authors: Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy.
authors: Giacomo
authors: G
authors: Faldella
mesh_terms: D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000151:congenital* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D042241:Early Diagnosis; D004453:Echoencephalography; D005260:Female; D005500:Follow-Up Studies; D006320:Hearing Tests; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: Cerebral MRI; Cytomegalovirus; Hearing loss; Neurodevelopment; Ultrasound