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Updated: Jul 22, 2026
Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
Fetal brain imaging provides valuable information in cCMV infected infants
A Kyriakopoulou1, V Papaevangelou1, M Argyropoulou2
1National and Kapodistrian University of Athens, Third Department of Paediatrics, Attikon General University Hospital, Athens, Greece.
Insights
Fetal MRI may offer similar prognostic information as neonatal MRI for asymptomatic congenital CMV infection. This study suggests fetal imaging could be a viable alternative for assessing long-term outcomes in newborns.
Area of Science:
- Neonatal neurology
- Congenital infections
- Medical imaging
Background:
- Congenital cytomegalovirus (cCMV) infection is the most common congenital infection, with 10-15% of cases resulting in symptomatic disease.
- Neonatal imaging, particularly MRI, is crucial for prognostication in symptomatic cCMV but less utilized in asymptomatic newborns due to practical challenges.
- Fetal imaging is explored as a potential alternative for assessing long-term sequelae in high-risk asymptomatic newborns.
Purpose of the Study:
- To compare the diagnostic utility of fetal MRI with neonatal MRI in asymptomatic newborns diagnosed with congenital CMV infection.
- To evaluate the concordance of findings between prenatal and postnatal imaging modalities.
Main Methods:
- A retrospective cohort study of 10 asymptomatic neonates with confirmed cCMV infection who underwent both fetal and neonatal MRI.
- Radiologists assessed MRIs using a checklist of cerebral abnormalities, comparing findings between fetal and neonatal scans.
- Concordance rates were calculated for reported abnormalities within each imaging type and between modalities.
Main Results:
- Overall concordance between fetal and neonatal MRI findings was 70%.
- High concordance was observed between blinded radiologists' reports for fetal (90%) and neonatal (100%) MRIs.
- The most frequent abnormalities identified in both imaging types included abnormal white matter hyperintensity and subependymal cysts.
Conclusions:
- Fetal MRI shows potential as a comparable imaging tool to neonatal MRI for evaluating asymptomatic congenital CMV infection.
- These findings support further investigation in larger studies to establish fetal MRI's role in managing cCMV.
- Fetal MRI may offer a more accessible and feasible option for prognostication in at-risk newborns.
Background:
Congenital CMV infection (cCMV) is the most common congenital infection with 10-15% of cases developing symptomatic disease. Early antiviral treatment is of essence when symptomatic disease is suspected. Recently, the use of neonatal imaging has been implicated as a prognostic tool for long term sequalae among asymptomatic newborns at high risk. Even though neonatal MRI is commonly used in neonatal symptomatic cCMV disease, it is less often used in asymptomatic newborns, mainly due to cost, access and difficulty to perform. We have therefore developed an interest in assessing the use of fetal imaging as an alternative. Our primary aim was to compare the fetal and neonatal MRIs in a small cohort 10 asymptomatic neonates with congenital CMV infection.
Methods:
We performed a single-center retrospective cohort study (case-series) on a convenience sample of children born from January 2014 to March 2021 with confirmed congenital CMV infection who had undergone both fetal and neonatal MRIs. We created a checklist of relevant cerebral abnormalities and asked 4 blinded radiologists to assess the MRIs (2 for each, namely fetal and neonatal) and then compared the findings between the fetal and neonatal imaging as well as the concordance in reporting of abnormalities within each category.
Findings:
Overall concordance between prenatal and postnatal scans was high (70%). When comparing the two blinded reports for each MRI, we found high levels of concordance: 90% concordance for fetal MRIs and 100% for neonatal MRIs. The most common abnormalities identified in both fetal and neonatal scans were "abnormal white matter hyperintensity" and "subependymal cysts."
Interpretation:
Even though this is a small descriptive study, it indicates that fetal MRI could potentially provide us with similar information as neonatal imaging. This study could form the basis for subsequent larger future studies.
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