Neuropediatrics 2009; 40(4): 168-173
DOI: 10.1055/s-0029-1243228
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Quantitative MR Imaging and Spectroscopy in Congenital Cytomegalovirus Infection and Periventricular Leukomalacia Suggests a Comparable Neuropathological Substrate of the Cerebral White Matter Lesions

J. P. van der Voorn1 , P. J. Pouwels2 , R. J. Vermeulen3 , F. Barkhof4 , M. S. van der Knaap3
  • 1Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  • 2Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
  • 3Department of Child Neurology, VU University Medical Center, Amsterdam, The Netherlands
  • 4Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Further Information

Publication History

received 27.05.2009

accepted 09.11.2009

Publication Date:
04 February 2010 (online)


Congenital cytomegalovirus (CMV) infection and periventricular leukomalacia (PVL) both lead to static cerebral white matter lesions. In contrast to PVL, the neuropathologicAL substrate of these lesions in congenital CMV is not clear. By comparing changes in quantitative magnetic resonance (MR) parameters and MR spectroscopy metabolite concentrations we wanted to determine whether the nature of the white matter pathology in congenital CMV infection could be similar to the known pathology of PVL. Diffusion parameters, apparent diffusion coefficient (ADC) and fractional anisotropy (FA), magnetization transfer ratio (MTR) and MR spectroscopy concentrations were studied in white matter lesions in five patients with a congenital CMV infection and six patients with PVL. In both groups ADC values were increased, FA and MTR values were reduced, concentrations of total N-acetylaspartate and choline-containing compounds were reduced; and myo-inositol concentrations were slightly increased. No differences were found between the two groups, suggesting that the pathology of the white matter lesions in congenital CMV infections is similar to that of PVL and also characterized by axonal losses, lack of myelin deposition due to oligodendrocytic losses, and astrogliosis. Congenital CMV infection and PVL affect the cerebral white matter in the same developmental period when immature oligodendrocytes are particularly vulnerable.



This article was changed according to the following erratum on March 01, 2010:

Some of the authors' names of this article were incorrect. The names of the authors should be as follows: van der Voorn JP, Pouwels PJ, Vermeulen RJ, Barkhof F, van der Knaap MS.


J. Patrick van der Voorn

Department of Pathology

VU University

Medical Center

De Boelelaan 1117

1007 MB Amsterdam

The Netherlands