title: Congenital cytomegalovirus infection: contribution and best timing of prenatal MR imaging.
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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.|Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Mieke M
authors.initials: MM
authors.lastname: Cannie
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: Department of Obstetrics, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Mina
authors.initials: M
authors.lastname: Leyder
authors.affiliation: Department of Radiology, University Hospitals Leuven, Leuven, Belgium.|Department of Radiology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Claus
authors.affiliation: Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Astrid
authors.initials: A
authors.lastname: Leus
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: De Catte
authors.affiliation: Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Cossey
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Ina
authors.initials: I
authors.lastname: Foulon
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Elise
authors.initials: E
authors.lastname: Van der Valk
authors.affiliation: Department of Obstetrics, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Foulon
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Fetal Medicine Unit, Place A. Van Gehuchten 4, 1020, Brussels, Belgium.
authors.forename: Teresa
authors.initials: T
authors.lastname: Cos
authors.affiliation: Department of Radiology, Sint-Augustinus Hospital, Antwerp, Belgium.
authors.forename: Anja
authors.initials: A
authors.lastname: Bernaert
authors.affiliation: Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Oyen
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Fetal Medicine Unit, Place A. Van Gehuchten 4, 1020, Brussels, Belgium. jackjani@hotmail.com.
authors.forename: Jacques C
authors.initials: JC
authors.lastname: Jani
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D005865:Gestational Age; D006319:Hearing Loss, Sensorineural / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D016216:Ultrasonography, Prenatal
keywords: Congenital CMV; Fetal MRI; Fetal infection; Polar temporal lesions; Sensorineural hearing loss