Alarcon et al graded MRI changes in the brain associated with congenital cytomegalovirus (CMV) infection. The authors are from Oxford University Hospitals, Hammersmith Hospital, Sant Joan de Deu University Hospital (Barcelona) and La Paz University Hospital (Madrid).
Exam: brain MRI
Ventriculomegaly: ventricular index > 97th percentile for gestational age in mm
Severe ventriculomegaly: ventricular index > 97th percentile in mm + 4 mm
Parameters:
(1) calcifications
(2) vasculopathy
(3) germinolysis
(4) ventricular index
(5) white matter signal abnormalities
(6) cortical changes
(7) corpus callosum
(8) cerebellar
Parameter |
Finding |
Points |
calcifications |
none |
0 |
|
single punctate periventricular |
1 |
|
multiple discrete periventricular |
2 |
|
extensive |
3 |
vasculopathy |
none |
0 |
|
lenticulostriate |
1 |
germinolysis |
none |
0 |
|
caudothalamic germinolysis |
1 |
|
paraventricular germinolytic cysts |
2 |
ventricular index |
normal |
0 |
|
ventriculomegaly, less than severe |
1 |
|
ventriculomegaly, severe |
2 |
white matter abnormalities |
none |
0 |
|
focal or multifocal white matter signal abnormalities |
1 |
|
diffuse white matter abnormalities |
2 |
cortical changes |
none |
0 |
|
temporal lobe involvement |
2 |
|
cortical malformations, abnormal gyrations, brain atrophy |
3 |
corpus callosum |
normal |
0 |
|
dysgenesis |
3 |
cerebellum |
normal |
0 |
|
hypoplasia |
3 |
grade =
= MAX(points for various parameters)
Interpretation:
• minimum grade: 0 (nromal)
• maximum grade: 3
Specialty: Infectious Diseases