[Detailed in utero ultrasound description of 34 cases of congenital cytomegalovirus infection]

J Gynecol Obstet Biol Reprod (Paris). 2016 Apr;45(4):397-406. doi: 10.1016/j.jgyn.2015.04.014. Epub 2015 Jun 19.
[Article in French]

Abstract

Objectives: To describe precisely prenatal ultrasound features in congenital cytomegalovirus (CMV) infection.

Material and methods: We retrospectively evaluated the ultrasound descriptions of cases of congenital CMV infection between 2004 and 2013.

Results: In 74 congenital CMV infections, related ultrasound abnormalities were reported in 34 cases (45.9%). Abnormalities reported were either cerebral (11 cases), either extracerebral (6 cases), or associated (17 cases). A total of 22/34 cases presented extracerebral features of 11 different sorts of abnormalities, mainly intra-uterine growth retardation (11 cases) and hyperechogenic bowel (10 cases) and 26/34 cases presented cerebral features of 14 different sorts, mainly brain calcifications (12 cases) and occipital horn cavity (12 cases). MRI was performed in 25 cases and have found additional abnormalities in 8 cases. These abnormalities are not specific to CMV infection. However, a frequent finding attracted our attention: the anechogenic cavity located on the extremity of the occipital horn.

Conclusion: A potentially specific sign, inexistent in other fetal pathologies, is an anechogenic cavity located on the extremity of the occipital and/or temporal horn, a germinal region which contains numerous proliferating and differentiating germinal cells. A better understanding of these signs could increase the sensitivity of ultrasound, and clarify the pathophysiology of congenital CMV infection.

Keywords: Congenital infection; Cytomegalovirus; Cytomégalovirus; Diagnostic anténatal; Infection congénitale; Prenatal diagnosis; Ultrasound; Échographie.

MeSH terms

  • Adult
  • Cytomegalovirus Infections* / complications
  • Cytomegalovirus Infections* / congenital
  • Cytomegalovirus Infections* / diagnostic imaging
  • Echogenic Bowel / diagnostic imaging*
  • Echogenic Bowel / etiology
  • Female
  • Fetal Growth Retardation / diagnostic imaging*
  • Fetal Growth Retardation / etiology
  • Humans
  • Nervous System Malformations / diagnostic imaging*
  • Nervous System Malformations / etiology
  • Pregnancy
  • Retrospective Studies
  • Ultrasonography, Prenatal / methods*