Supplementary Material for: Prediction of Neurodevelopmental Impairment in Congenital Cytomegalovirus Infection by Early Postnatal Magnetic Resonance Imaging

Introduction: Congenital cytomegalovirus infection (CCMVI) may result in neurodevelopmental impairments (NDIs) such as hearing loss, developmental delay, epilepsy, and cerebral palsy. We aimed to investigate the potential for brain magnetic resonance imaging (MRI) to predict NDI in patients with CCMVI. Methods: We studied infants with CCMVI who were referred to our hospital from April 2010 to October 2018 and underwent a brain MRI within 3 months since birth. We screened for 6 classic presentations of CCMVI including ventriculomegaly, periventricular cysts, hippocampal dysplasia, cerebellar hypoplasia, migration disorders, and white matter abnormalities. Images were interpreted by a blinded pediatric radiologist. NDI was defined as having a developmental quotient Results: The study involved 42 infants with CCMVI (median gestational age 38 weeks, birthweight 2,516 g). At least one abnormal finding was detected in 28 (67%) infants. Abnormal findings consisted of 3 cerebellar hypoplasia (7%), 7 migration disorders (17%), 26 white matter abnormalities (62%), 12 periventricular cysts (28%), 1 hippocampal dysplasia (2%), and 20 ventriculomegaly (48%). Abnormal findings were significantly more prevalent in infants with clinical symptoms (21/24, 91%) than in those without (7/19, 37%, p Conclusion: Infants with CCMVI with at least 2 of the abovementioned specific brain image abnormalities may be at high risk of developing NDI.引言：先天性巨细胞病毒感染（Congenital cytomegalovirus infection, CCMVI）可引发听力损失、发育迟缓、癫痫、脑瘫等神经发育障碍（Neurodevelopmental impairments, NDIs）。本研究旨在探讨脑磁共振成像（brain magnetic resonance imaging, MRI）在先天性巨细胞病毒感染患儿中预测神经发育障碍的应用潜力。 方法：本研究纳入2010年4月至2018年10月间转诊至本院的先天性巨细胞病毒感染患儿，所有受试者均于出生后3个月内接受脑部磁共振成像检查。我们筛查了先天性巨细胞病毒感染的6种典型影像学表现，包括脑室扩大、脑室周围囊肿、海马发育不良、小脑发育不全、神经元迁移障碍及白质异常。影像结果由采用盲法的儿科放射科医师进行判读。神经发育障碍定义为发育商（developmental quotient）。 结果：本研究共纳入42名先天性巨细胞病毒感染患儿（中位胎龄38周，出生体重2516g）。其中28名（67%）患儿检出至少1项异常影像学表现。异常表现具体为：小脑发育不全3例（7%）、神经元迁移障碍7例（17%）、白质异常26例（62%）、脑室周围囊肿12例（28%）、海马发育不良1例（2%）、脑室扩大20例（48%）。有临床症状患儿的异常影像学检出率（21/24，91%）显著高于无临床症状患儿（7/19，37%，p）。 结论：伴有至少2项上述特异性脑影像异常的先天性巨细胞病毒感染患儿，发生神经发育障碍的风险较高。