EC Gynaecology

Objectives: This study aimed to assess qualitatively and quantitatively the laminar organization of the cerebral cortex by prenatal ultrasound and MRI in cytomegalovirus-infected fetuses.

Methods: A retrospective study was conducted in 18 fetuses with a positive CMV PCR-analysis of amniotic fluid. All cases underwent serial ultrasound scans and at least one MR study before 28 weeks of gestation. Eleven cases with prenatal ultrasound diagnosis of CMV infection leading to termination were compared with the 7 cases going to term.

MRI detected 2 patterns of abnormal cerebral lamination: focal disruption of lamination and abnormal intermediate zone. On ultrasound, the laminar structure was visible as the interface between the subplate zone and the intermediate zone, quantitatively evaluated by measuring the distances between the different layers.

Results: In the TOP group, MRI showed focal disruption of lamination and abnormal intermediate zone in 3/11 and 11/11 cases respectively. In the TERM group, none of them had a disruption of lamination on MRI, however 3 had an abnormal intermediate zone.

On ultrasound, the posterior horn of the lateral ventricle was significantly larger in the TOP group compared to the TERM group. Measurement of the thickness of the subplate zone relative to the intermediate zone did not significantly differ between both groups.

Conclusion: The lamination pattern of the fetal brain can be evaluated qualitatively on MRI and ultrasound before 28 weeks and may indicate abnormal brain development in CMV-infected fetuses. Quantitative differences in lamination were not demonstrated on ultrasound.

 Keywords: Cytomegalovirus; Lamination; Fetal MRI; Fetal Ultrasound; Brain

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