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Quantitative evaluation of ventricular dilatation using computed tomography in infants with congenital cytomegalovirus infection
Authors:Kiyomi Matsuo  Ichiro Morioka  Mai Oda  Yoko Kobayashi  Yuji Nakamachi  Seiji Kawano  Miwako Nagasaka  Tsubasa Koda  Tomoyuki Yokota  Satoru Morikawa  Akihiro Miwa  Akio Shibata  Toshio Minematsu  Naoki Inoue  Hideto Yamada  Kazumoto Iijima
Affiliation:1. Department of Pediatrics, Kobe University Hospital, Kobe, Japan;2. Department of Radiology, Kobe University Hospital, Kobe, Japan;3. Department of Obstetrics and Gynecology, Kobe University Hospital, Kobe, Japan;4. Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan;5. Research Center for Disease Control, Aisenkai Nichinan Hospital, Nichinan, Japan;6. Department of Virology I, National Institute of Infectious Disease, Tokyo, Japan
Abstract:

Background

Infants with congenital cytomegalovirus infection (CCMVI) may develop brain abnormalities such as ventricular dilatation, which may potentially associate with sensorineural hearing loss. There is currently no recognized method for quantitative evaluation of ventricle size in infants with CCMVI. Our objectives were to establish a method for quantitative evaluation of ventricle size using computed tomography (CT) in infants with CCMVI, and determine a cut-off value associated with abnormal auditory brainstem response (ABR) early in life.

Design/Subjects

This study enrolled 19 infants with CCMVI and 21 non-infected newborn infants as a control group. Infants with CCMVI were divided into two subgroups according to ABR at the time of initial examination: normal ABR (11 infants) or abnormal ABR (8 infants). Ventricle size was assessed by calculating Evans’ index (EI) and lateral ventricle width/hemispheric width (LVW/HW) ratio on brain CT images, and was compared among groups. A cut-off ventricle size associated with abnormal ABR was determined.

Results

EI and LVW/HW ratio were significantly higher in the CCMVI with abnormal ABR group than the control and CCMVI with normal ABR groups. Cut-off values of 0.26 for EI and 0.28 for LVW/HW ratio had a sensitivity of 100% and 100%, respectively, and a specificity of 73% and 91%, respectively, for association with abnormal ABR.

Conclusions

We established a method for quantitative evaluation of ventricle size using EI and LVW/HW ratio on brain CT images in infants with CCMVI. LVW/HW ratio had a more association with abnormal ABR in the early postnatal period than EI.
Keywords:Auditory brainstem response   Cytomegalovirus infection   Evans&rsquo   index   Lateral ventricle width/hemispheric width ratio   Ventricle
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