The prognostic relevance of fetal/early postnatal magnetic resonance (MR) imaging (MRI) isolated “minor” lesions in congenital cytomegalovirus (CMV) infection is still unclear, because of the heterogeneity of previously reported case series. The aim of this study was to report the imaging and long-term clinical follow-up data on a relatively large cohort of infected fetuses. Among 140 CMV-infected fetuses from a single-center 12-year-long fetal MRI database, cases that showed isolated “minor” lesions at MRI, mainly represented by polar temporal lesions, were selected. MRI features were described, and clinical follow-up information was collected through consultation of medical records and telephone interview to establish the auditory and neurological outcome of each patient. Thirty-six cases were included in the study. The frequency of “minor” lesions increased progressively with ongoing gestational age in cases who underwent serial MR examination; 31% of cases were symptomatic at birth for unilateral altered auditory brainstem response. At long-term clinical follow-up, performed in 35 patients at a mean age of 64.5 months (range: 25 to 138), 43% of patients were asymptomatic and 57% presented with mild/moderate disability including hearing loss (34%), unilateral in all cases but one (therefore classified as severe), and/or minor cognitive and behavioral disorders (49%). Descriptive analysis of the type and modality of occurrence of “minor” lesions suggests performing serial fetal/postnatal MR examinations not to miss later-onset lesions. Follow-up data from the present cohort, combined with maternal/fetal factors and serologic-laboratory parameters may contribute to improve prenatal and neonatal period counselling skills.

中文翻译：

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先天性巨细胞病毒感染并伴有胎儿磁共振成像孤立的“轻微”病变：长期神经系统结果

由于先前报道的病例系列的异质性，先天性巨细胞病毒（CMV）感染中胎儿/出生后早期磁共振（MR）成像（MRI）孤立“轻微”病变的预后相关性仍不清楚。本研究的目的是报告相对较大的受感染胎儿队列的影像学和长期临床随访数据。从单中心长达12年的胎儿MRI数据库中收集的140个CMV感染胎儿中，选择了MRI显示孤立的“轻微”病变（主要表现为极颞叶病变）的病例。描述了 MRI 特征，并通过查阅病历和电话访谈收集临床随访信息，以确定每位患者的听觉和神经系统结果。该研究纳入了 36 例病例。在接受系列 MR 检查的病例中，“轻微”病变的频率随着胎龄的增加而逐渐增加； 31% 的病例在出生时就出现单侧听觉脑干反应改变的症状。在对 35 名平均年龄为 64.5 个月的患者（范围：25 至 138 岁）进行的长期临床随访中，43% 的患者没有症状，57% 的患者出现轻度/中度残疾，包括听力损失 (34%) ，除一例（因此被归类为严重）和/或轻微认知和行为障碍外，所有病例均为单侧（49%）。对“轻微”病变发生的类型和方式的描述性分析表明，进行连续的胎儿/产后 MR 检查，以免错过后来发生的病变。当前队列的随访数据，结合母体/胎儿因素和血清学实验室参数，可能有助于提高产前和新生儿期咨询技能。