Brain Metabolite Differences in Fetuses With Cytomegalovirus Infection: A Magnetic Resonance Spectroscopy Study

• Published in: Journal of magnetic resonance imaging 2024-07
• Main Authors: Sadan, Or R, Avisdris, Netanell, Rabinowich, Aviad, Link-Sourani, Daphna, Krajden Haratz, Karina, Garel, Catherine, Hiersch, Liran, Ben Sira, Liat, Ben Bashat, Dafna
• Format: Article
• Language: English
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.29507

Cytomegalovirus (CMV) is the most common intrauterine infection and may be associated with unfavorable outcomes. While some CMV-infected fetuses may show gross or subtle brain abnormalities on MRI, their clinical significance may be unclear. Conversely, normal development cannot be guaranteed in CMV-infected fetuses with normal MRI. To assess brain metabolite differences in CMV-infected fetuses using magnetic resonance spectroscopy (MRS). Retrospective. Out of a cohort of 149 cases, 44 with maternal CMV infection, amniocentesis results, and good-quality MRS were included. CMV-infected fetuses with positive polymerase chain reaction (PCR) (N = 35) were divided based on MRI results as follows: typical brain abnormalities (gross findings, N = 8), exclusive white matter hyperintense signal (WMHS) on T -weighted images (subtle findings, N = 7), and normal MRI (N = 20). Uninfected fetuses (negative PCR) with normal MRI were included as controls (N = 9). 3 T, T -weighted half Fourier single-shot turbo spin-echo (HASTE), T -weighted true fast imaging with steady-state free precession (TrueFISP), T - and T *-weighted fast low angle shot (FLASH), and H-MRS single-voxel point resolved spectroscopy (PRESS) sequences. MRI findings were assessed by three radiologists, and metabolic ratios within the basal ganglia were calculated using LCModel. Analysis of covariance test with Bonferroni correction for multiple comparisons was used to compare metabolic ratios between groups while accounting for gestational age. A P-value