Congenital Brain Abnormalities and Zika Virus: What the Radiologist Can Expect to See Prenatally and Postnatally

Congenital Brain Abnormalities and Zika Virus: What the Radiologist Can Expect to See Prenatally and Postnatally

Author Oliveira-Szejnfeld, Patricia Soares de Autor UNIFESP Google Scholar
Levine, Deborah Google Scholar
de Oliveira Melo, Adriana Suely Google Scholar
Ramos Amorim, Melania Maria Google Scholar
Batista, Alba Gean M. Google Scholar
Chimelli, Leila Google Scholar
Tanuri, Amilcar Google Scholar
Aguiar, Renato Santana Google Scholar
Malinger, Gustavo Google Scholar
Ximenes, Renato Autor UNIFESP Google Scholar
Robertson, Richard Google Scholar
Szejnfeld, Jacob Autor UNIFESP Google Scholar
Tovar-Moll, Fernanda Google Scholar
Abstract Purpose: To document the imaging findings associated with congenital Zika virus infection as found in the Instituto de Pesquisa in Campina Grande State Paraiba (IPESQ) in northeastern Brazil, where the congenital infection has been particularly severe. Materials and Methods: From June 2015 to May 2016, 438 patients were referred to the IPESQ for rash occurring during pregnancy or for suspected fetal central nervous system abnormality. Patients who underwent imaging at IPESQ were included, as well as those with documented Zika virus infection in fluid or tissue (n = 17, confirmed infection cohort) or those with brain findings suspicious for Zika virus infection, with intracranial calcifications (n = 28, presumed infection cohort). Imaging examinations included 12 fetal magnetic resonance (MR) examinations, 42 postnatal brain computed tomographic examinations, and 11 postnatal brain MR examinations. Images were reviewed by four radiologists, with final opinion achieved by means of consensus. Results: Brain abnormalities seen in confirmed (n = 17) and presumed (n = 28) congenital Zika virus infections were similar, with ventriculomegaly in 16 of 17 (94%) and 27 of 28 (96%) infections, respectively

abnormalities of the corpus callosum in 16 of 17 (94%) and 22 of 28 (78%) infections, respectively

and cortical migrational abnormalities in 16 of 17 (94%) and 28 of 28 (100%) infections, respectively. Although most fetuses underwent at least one examination that showed head circumference below the 5th percentile, head circumference could be normal in the presence of severe ventriculomegaly (seen in three fetuses). Intracranial calcifications were most commonly seen at the gray matter-white matter junction, in 15 of 17 (88%) and 28 of 28 (100%) confirmed and presumed infections, respectively. The basal ganglia and/or thalamus were also commonly involved with calcifications in 11 of 17 (65%) and 18 of 28 (64%) infections, respectively. The skull frequently had a collapsed appearance with overlapping sutures and redundant skin folds and, occasionally, intracranial herniation of orbital fat and clot in the confluence of sinuses. Conclusion: The spectrum of findings associated with congenital Zika virus infection in the IPESQ in northeastern Brazil is illustrated to aid the radiologist in identifying Zika virus infection at imaging. (C) RSNA, 2016
xmlui.dri2xhtml.METS-1.0.item-coverage Oak Brook
Language English
Date 2016
Published in Radiology. Oak Brook, v. 281, n. 1, p. 203-218, 2016.
ISSN 0033-8419 (Sherpa/Romeo, impact factor)
Publisher Radiological Soc North America
Extent 203-218
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000391313600023

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