Purpose: CMV is part of TORCH and is the most common cause of congenital neurologic disability due to infection. The disease is expressed by nonspecific changes in the periventricular white matter and by other findings. In adults T2FLAIR series are more sensitive to white matter lesions than T2 series. This work is aimed at identifying early MRI changes in the white matter of fetuses with maternal CMV infection, and to investigate whether T2FLAIR will improve the detection of these changes.
Methods: It is a retrospective study of 207 women with established CMV infection examined at the Sheba Medical Center from 2013 to 2016. MRIs including T2 and T2 FLAIR series were performed in the third trimester without injection of contrast material. The imaging evaluation compared the findings on the T2 to the T2 FLAIR series. Some of the women underwent amniocentesis at different stages of pregnancy.
Results: T2 series showed nonspecific changes in the white matter, mainly in the temporal and frontal lobes in 24 of 160 fetuses. In none of the examinations the abnormal findings were seen on the T2 FLAIR series.
Conclusions: In contrast to adult MRI, T2 FLAIR was not useful in the evaluation of early changes in the white matter on fetal MRI. Therefore, omitting this series does not affect the diagnostic quality of the examination. The reason for this lack of sensitivity requires further study.
