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Research ArticlePediatric Neuroimaging

Apparent Diffusion Coefficient Value Changes and Clinical Correlation in 90 Cases of Cytomegalovirus-Infected Fetuses with Unremarkable Fetal MRI Results

D. Kotovich, J.S.B. Guedalia, C. Hoffmann, G. Sze, A. Eisenkraft and G. Yaniv
American Journal of Neuroradiology July 2017, 38 (7) 1443-1448; DOI: https://doi.org/10.3174/ajnr.A5222
D. Kotovich
aFrom The Faculty of Medicine (D.K., A.E.), Institute for Research in Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
bThe Israel Defense Forces Medical Corps (D.K., A.E.), Chevy Chase, Maryland
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J.S.B. Guedalia
cNeuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel
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C. Hoffmann
dDepartment of Diagnostic Imaging (C.H.)
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G. Sze
fDepartment of Radiology and Biomedical Imaging (G.S., G.Y.), Yale School of Medicine, New Haven, Connecticut.
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A. Eisenkraft
aFrom The Faculty of Medicine (D.K., A.E.), Institute for Research in Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
bThe Israel Defense Forces Medical Corps (D.K., A.E.), Chevy Chase, Maryland
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G. Yaniv
cNeuropsychology Unit (J.S.B.G., G.Y.), Shaare Zedek Medical Center, Jerusalem, Israel
eDr. Pinchas Bornstein Talpiot Medical Leadership Program (G.Y.), Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
fDepartment of Radiology and Biomedical Imaging (G.S., G.Y.), Yale School of Medicine, New Haven, Connecticut.
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    Fig 1.

    ROI analyzed for apparent diffusion coefficient. ROI placement example. A, 1, 2 = frontal lobe; 3, 4 = parietal lobe. B, 5, 6 = basal ganglia. C, 7, 8 = thalami. D, 9, 10 = temporal lobe; 11, 12 = occipital lobe. E, 13 = pons. F, 14, 15 = cerebellum.

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    Fig 2.

    Comparison between ADC values (in millions) of different brain regions from CMV-infected fetuses (gray) and a control group (black). A significant difference is shown with an asterisk.

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    Fig 3.

    Vineland domains and subdomain absolute results distribution by category of the CMV-infected group (gray) compared with the normal expected distribution (black). Only significant results are shown.

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    Fig 4.

    Correlation between ADC values (in millions) by brain regions and Vineland results by domains or subdomains of neonatal CMV-infected children, including only children without hearing disabilities and Vineland results. Only significant results are shown. BG indicates basal ganglia; Avg., average.

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    Table 1:

    Descriptive data of the fetuses included in the study

    ControlsCMV Group
    No. (feMRI)6890
    Maternal age (mean) (yr)32.05 ± 4.4331.58 ± 4.23
    GA (MRI) (mean)31.8 ± 2.333.1 ± 2.0
    GA (infection, No.)NA
        1st trimester25
        2nd trimester43
        3rd trimester15
        Unknown7
    VABS–IINA58
        Child's age (mean) (mo)60.12 ± 30.774
        Male (No.)32
            Mean age (mo)50.75 ± 26.3
        Female (No.)26
            Mean age (mo)71.65 ± 32.4
        Hearing disabilities (No.)8 (14%)
    • Note:—GA indicates gestational age; NA, not applicable.

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    Table 2:

    Regional effects of cytomegalovirus infection on fetal brain ADCa

    RegionControls ± SDCMV Group ± SDP Value
    Frontal lobe1762.3 ± 191.61675.0 ± 190.3.005
    Parietal lobe1733.9 ± 228.91637.2 ± 220.5.008
    Occipital lobe1700.2 ± 193.71629.9 ± 186.7.022
    Temporal lobe1687.5 ± 172.51636.7 ± 159.1.057
    Basal ganglia1448.5 ± 212.31375.2 ± 147.3.016
    Thalamus1354.2 ± 220.71247.2 ± 155.3<.001
    Cerebellum1486.3 ± 198.71407.5 ± 152.5.005
    Pons1359.2 ± 189.31286.3 ± 164.7.011
    • ↵a Data are means. ADC units are 106 mm2/s.

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American Journal of Neuroradiology: 38 (7)
American Journal of Neuroradiology
Vol. 38, Issue 7
1 Jul 2017
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D. Kotovich, J.S.B. Guedalia, C. Hoffmann, G. Sze, A. Eisenkraft, G. Yaniv
Apparent Diffusion Coefficient Value Changes and Clinical Correlation in 90 Cases of Cytomegalovirus-Infected Fetuses with Unremarkable Fetal MRI Results
American Journal of Neuroradiology Jul 2017, 38 (7) 1443-1448; DOI: 10.3174/ajnr.A5222

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Apparent Diffusion Coefficient Value Changes and Clinical Correlation in 90 Cases of Cytomegalovirus-Infected Fetuses with Unremarkable Fetal MRI Results
D. Kotovich, J.S.B. Guedalia, C. Hoffmann, G. Sze, A. Eisenkraft, G. Yaniv
American Journal of Neuroradiology Jul 2017, 38 (7) 1443-1448; DOI: 10.3174/ajnr.A5222
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