title: Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis.
abstract: OBJECTIVE
  Arthrogryposis is among the malformations of congenital Zika syndrome. Similar to the brain, there might exist a spectrum of spinal cord abnormalities. The purpose of this study was to explore and describe in detail the MR imaging features found in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome with and without arthrogryposis.
  
  
  METHODS
  Twelve infants with congenital Zika syndrome (4 with arthrogryposis and 8 without) who had undergone brain and spinal cord MR imaging were retrospectively selected. Qualitative and quantitative analyses were performed and compared between groups.
  
  
  RESULTS
  At visual inspection, both groups showed reduced thoracic spinal cord thickness: 75% (6/8) of the group without arthrogryposis and 100% (4/4) of the arthrogryposis group. However, the latter had the entire spinal cord reduced and more severely reduced conus medullaris anterior roots (respectively,P= .002 and .007). Quantitative differences were found for conus medullaris base and cervical and lumbar intumescences diameters (respectively,P= .008, .048, .008), with more prominent reduction in arthrogryposis. Periventricular calcifications were more frequent in infants with arthrogryposis (P= .018).
  
  
  CONCLUSIONS
  Most infants had some degree of spinal cord thickness reduction, predominant in the thoracic segment (without arthrogryposis) or in the entire spinal cord (with arthrogryposis). The conus medullaris anterior roots were reduced in both groups (thinner in arthrogryposis). A prominent anterior median fissure of the spinal cord was absent in infants without arthrogryposis. Brain stem hypoplasia was present in all infants with arthrogryposis, periventricular calcifications, in the majority, and polymicrogyria was absent.
authors.affiliation: From the Centro Diagnostico Multimagem (M.F.V.V.A.), Recife, Brazil fatima.vascoaragao@gmail.com.|Mauricio de Nassau University (M.F.V.V.A., A.M.B.-L.), Recife, Brazil.
authors.forename: M F V V
authors.identifier: http://orcid.org/0000-0002-2341-1422
authors.initials: MFVV
authors.lastname: Aragao
authors.affiliation: PROCAPE (A.M.B.-L.), University of Pernambuco, Recife, Brazil.|Mauricio de Nassau University (M.F.V.V.A., A.M.B.-L.), Recife, Brazil.
authors.forename: A M
authors.identifier: http://orcid.org/0000-0003-0096-4101
authors.initials: AM
authors.lastname: Brainer-Lima
authors.affiliation: Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil.
authors.forename: A C
authors.identifier: http://orcid.org/0000-0002-4127-2366
authors.initials: AC
authors.lastname: Holanda
authors.affiliation: Association for Assistance of Disabled Children (V.v.d.L.), Recife, Brazil.|Barão de Lucena Hospital (V.v.d.L., N.C.L.P.), Recife, Brazil.
authors.forename: V
authors.identifier: http://orcid.org/0000-0003-1641-9386
authors.initials: V
authors.lastname: van der Linden
authors.affiliation: Prof Fernando Figueira Integral Medicine Institute (L.V.A.), Recife, Brazil.
authors.forename: L
authors.identifier: http://orcid.org/0000-0001-7132-8634
authors.initials: L
authors.lastname: Vasco Aragão
authors.affiliation: Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil.
authors.forename: M L M
authors.identifier: http://orcid.org/0000-0002-9002-107X
authors.initials: MLM
authors.lastname: Silva Júnior
authors.affiliation: Fundação Oswaldo Cruz-Fiocruz/PE (C.S.), Recife, Brazil.
authors.forename: C
authors.identifier: http://orcid.org/0000-0001-8536-0598
authors.initials: C
authors.lastname: Sarteschi
authors.affiliation: Barão de Lucena Hospital (V.v.d.L., N.C.L.P.), Recife, Brazil.
authors.forename: N C L
authors.identifier: http://orcid.org/0000-0002-4418-9429
authors.initials: NCL
authors.lastname: Petribu
authors.affiliation: Federal University of Pernambuco (A.C.H., M.L.M.S.J., M.M.V.), Recife, Brazil.
authors.forename: M M
authors.identifier: http://orcid.org/0000-0003-0678-3782
authors.initials: MM
authors.lastname: Valença
mesh_terms: D001176:Arthrogryposis / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology*; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging / Q000473:pathology*; D013577:Syndrome; D000071243:Zika Virus Infection / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*