Prenatal imaging findings in fetal Zika virus infection
Edward Araujo Júnior1, Francisco H C Carvalho, Gabriele Tonni
1aDepartment of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, São Paulo bDepartment of Maternal and Child, Federal University of Ceará (UFC), Fortaleza, Ceará, Brazil cDepartment of Obstetrics and Gynecology, Guastalla Civil Hospital, AUSL, Reggio Emilia, Italy dDepartment of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Rio de Janeiro, Brazil.
Purpose Of Review:
The aim of this review is to report the most recent observations concerning intrauterine Zika virus (ZIKV) infection and associated neuroimaging.
Recent Findings:
ZIKV outbreak in Brazil in 2015 was associated with an impressive registration of cases of congenital microcephaly in women with symptoms suggestive of ZIKV infection. Clinical and laboratory testing for ZIKV and hypothetic etiopathogenetic mechanisms are described. Diagnostic tests on blood, urine and amniotic fluid should be performed in all mothers with symptoms suggestive of intrauterine ZIKV infection. ZIKV causes multiple teratogenic malformations, mainly affecting the developing brain.
Summary:
Neuroimaging investigation contributes to the prenatal detection of microcephaly and other brain abnormalities in cases of intrauterine ZIKV infection. Neuroimaging is based antenatally on two-dimensional and three-dimensional ultrasound and fetal MRI, whereas computed tomography scan is performed postnatally. Although neuropathology associated with intrauterine ZIKV infection is characterized by nonspecific findings of brain disorder, reduced cortical gyration and white-matter hypomyelination or dysmyelination and cerebellar hypoplasia have been consistently observed in the majority of fetuses and newborns. Prenatal or postnatal genetic workup should be carried out to exclude cases of primary microcephaly. Follow-up should rely upon MRI and computed tomography scan as well as neuropediatrician to better define developmental outcome in survivors.
