Related Experiment Video
Updated: Jun 13, 2026
Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
Early cerebral lesions in cytomegalovirus infection: prenatal MR imaging
Chiara Doneda1, Cecilia Parazzini, Andrea Righini
1Department of Radiology and Neuroradiology, Children's Hospital V. Buzzi, Intermediate Care Program, Via Castelvetro 32, 20154 Milan, Italy. chiara.doneda@icp.mi .it
Purpose:
To assess the diagnostic and prognostic value of fetal cerebral magnetic resonance (MR) imaging of congenital cytomegalovirus (CMV) infection in comparison with that of level II ultrasonography (US).
Materials And Methods:
Institutional review board approval and informed consent for fetal MR imaging and data collection were obtained. Thirty-eight fetuses with CMV infection, examined by using serial level II US, underwent fetal MR imaging (mean gestational age, 25 weeks; age range at first fetal MR examination, 20-34 weeks). The frequency of pathologic findings at US (29 cases with transabdominal examination and nine cases with both transabdominal and transvaginal examination) and MR imaging was calculated, and a comparison between techniques by considering number (paired Student t test) and type (McNemar test) of finding was made. A comparison (paired Student t test) in cases of repeated fetal (nine of 38) and/or postnatal (14 of 38) MR imaging was obtained. Diagnostic and prognostic sensitivity was calculated for both techniques.
Results:
US and MR imaging findings were both normal in 47% of cases (18 of 38). Abnormal studies were reported in 26% (10 of 38) of US and 53% (20 of 38) of MR imaging cases. In 47% of cases (18 of 38), MR imaging provided additional information (P = .0002). MR imaging had better results than US in detecting polar temporal lesions (P = .0001), microencephaly (P = .03), and cortical anomalies (P = .06). In 44.5% of cases (four of nine), the second fetal MR examination results showed new findings (P = .05). In 79% of cases, postnatal MR imaging results confirmed prenatal findings (P = .08). MR imaging had higher sensitivity than US in detecting brain anomalies (92% vs 38%) and in predicting symptomatic infection (83% vs 33%). US and MR imaging revealed low positive predictive values (29% vs 36%).
Conclusion:
Fetal MR imaging results can show abnormalities in the fetal brain after CMV infection, even when US results are normal. The early detection of some brain abnormalities, such as microencephaly and cortical anomalies, may substantially influence the prognosis of fetal infection.
Insights
Fetal magnetic resonance (MR) imaging detects more congenital cytomegalovirus (CMV) brain abnormalities than ultrasonography (US), even when US is normal. Early MR detection of anomalies like microcephaly can improve prognosis for fetal CMV infection.
Area of Science:
- Medical Imaging
- Neurology
- Infectious Diseases
Background:
- Congenital cytomegalovirus (CMV) infection is a leading cause of non-genetic sensorineural hearing loss and neurodevelopmental disability.
- Accurate prenatal diagnosis of fetal brain involvement is crucial for prognosis and management.
- Level II ultrasonography (US) is the primary imaging modality, but its sensitivity for detecting subtle brain anomalies is limited.
Purpose of the Study:
- To compare the diagnostic and prognostic value of fetal cerebral magnetic resonance (MR) imaging versus level II US for congenital CMV infection.
- To evaluate the ability of MR imaging to detect brain abnormalities missed by US.
Main Methods:
- A cohort of 38 fetuses with confirmed CMV infection underwent serial level II US and fetal MR imaging.
- Imaging findings were compared for the number and type of abnormalities detected.
- Diagnostic and prognostic sensitivity of both techniques were calculated.
Main Results:
- MR imaging detected abnormalities in 53% of cases compared to 26% for US.
- MR imaging provided additional diagnostic information in 47% of cases, significantly outperforming US in detecting specific lesions like polar temporal lesions, microcephaly, and cortical anomalies.
- MR imaging demonstrated higher sensitivity for detecting brain anomalies (92% vs. 38%) and predicting symptomatic infection (83% vs. 33%).
Conclusions:
- Fetal MR imaging is superior to US in detecting brain abnormalities associated with congenital CMV infection.
- Early identification of anomalies such as microcephaly and cortical malformations by MR imaging can significantly impact the prognosis of affected fetuses.
- MR imaging offers valuable insights into the extent and implications of fetal brain injury in CMV infection.
