Brain MRI Findings of Congenital CMV Infection as a Prognostic Factor for Neurologic Outcome

Publication date: Available online 21 March 2018
Source:Pediatric Neurology
Author(s): Minsun Kwak, Mi-Sun Yum, Hye-Ryun Yeh, Hyun-Jin Kim, Tae-Sung Ko
Background: To predict the neurologic outcomes of patients with congenital cytomegalovirus (CMV) infection by analysis of magnetic resonance images of the brain. Methods: From June 2007 to June 2016, 31 patients diagnosed with symptomatic congenital CMV infection were identified at Asan Medical Center. The medical records and MRI findings of these patients were retrospectively reviewed, and relationships between MRI findings and neurologic outcomes were analyzed. Results Of the 31 patients, 17 were male and 12 had premature births (GA <37 weeks). Twenty-one patients presented with delayed development, 11 with microcephaly, and 10 with sensorineural hearing loss (SNHL), and 11 developed epilepsy. The most common abnormal findings on brain MRI were ventriculomegaly (N = 21, 67.7%) and polymicrogyria (N = 14, 45.2%). Delayed development significantly correlated with the presence of polymicrogyria (p = 0.001). Epilepsy was significantly associated with polymicrogyria (p = 0.012), ventriculomegaly (p = 0.045), calcification (p = 0.006), and white matter abnormalities (p = 0.018). SNHL was not associated with any abnormal findings on brain MRI. Based on these data, a new brain MR CMV scoring scale was built and this brain MR CMV scoring scale can predict the development of epilepsy with OR 3.62 (CI; 1.52-8.67, p = 0.004). Conclusion In patients with congenital CMV infections, brain MRI abnormalities could predict poor developmental outcomes and epilepsy, but not SNHL. Stratified MR findings can be suggested as the predictors of neurologic outcomes in patients with congenital CMV infections.



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