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Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without
M F V V Aragao1,2, A M Brainer-Lima3,2, A C Holanda4
1From the Centro Diagnostico Multimagem (M.F.V.V.A.), Recife, Brazil fatima.vascoaragao@gmail.com.
Background And Purpose:
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.
Materials And 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.
Insights
Congenital Zika syndrome can cause spinal cord abnormalities, with arthrogryposis linked to more severe reductions in spinal cord thickness and nerve roots. Imaging reveals distinct patterns in affected infants.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Congenital Zika syndrome is associated with various malformations.
- Arthrogryposis is a known complication, and spinal cord abnormalities may also occur.
- The spectrum of central nervous system involvement requires detailed investigation.
Purpose of the Study:
- To detail MR imaging findings in the spinal cords, nerve roots, and brains of children with congenital Zika syndrome.
- To compare imaging features between infants with and without arthrogryposis.
- To elucidate the relationship between arthrogryposis and spinal cord malformations in congenital Zika syndrome.
Main Methods:
- Retrospective analysis of MR imaging data from twelve infants with congenital Zika syndrome.
- Four infants had arthrogryposis; eight did not.
- Qualitative and quantitative imaging analyses were performed and compared between groups.
Main Results:
- Reduced thoracic spinal cord thickness was observed in both groups, more severe and affecting the entire cord in arthrogryposis cases.
- Conus medullaris anterior roots were significantly reduced, particularly in the arthrogryposis group.
- Periventricular calcifications were more frequent in infants with arthrogryposis; brainstem hypoplasia was universal in this subgroup.
Conclusions:
- Spinal cord abnormalities are common in congenital Zika syndrome, with arthrogryposis correlating with more severe involvement.
- Distinct imaging features differentiate spinal cord changes in infants with and without arthrogryposis.
- MR imaging is crucial for characterizing neurological sequelae of congenital Zika syndrome.
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