OC10.02: Correlation between sonographic and histopathologic patterns in periventricular severe human cytomegalovirus‐related lesions: a case series

We collected cases of fetuses with Human Cytomegalovirus (HCMV) and severe neurosonographic alterations. At the 20 weeks scan, two main periventricular patterns seemed to emerge: 1) uneven hyperechoic; 2) homogeneous hyperechoic. At the postmortem (PM) examination of the fetuses undergoing termination of pregnancy (TOP) at 22 gestational weeks, brain tissue samples showed two different patterns: Mottled) patchy tissue with alternating cellular/pseudonodular areas and edematous regions; Linear) homogeneous tissue with uniform distribution of cellularity and edema. Here, we demonstrate a correlation between periventricular sonographic and histopathologic patterns in severe HCMV. The study consisted in the retrospective revision (2012-2021) of severely-affected fetuses with HCMV infection referred to San Matteo Hospital (Pavia-Italy) with TOP in the II trimester. Neurosonographic images obtained at 20 gestational weeks were revised and assigned to show Type 1/Type 2 patterns. The corresponding histopathological brain tissue samples obtained from PM were revised blindly and labelled as Mottled or Linear. Of 325 mothers with HCMV, 65 cases exhibited vertical transmission at amniocentesis. 10 cases showed severe neurosonographic features and were terminated in the II trimester. In 9/10 cases, the blind assignment of Pattern 1 with Mottled, and Pattern 2 with Linear converged, leaving one case as uncertain. The study suggests a relation between sonographic Pattern 1 and histopathologic Mottled pattern, and between Pattern 2 and Linear pattern. Additional investigations are needed to detail timeline and development of the lesion, and their possible neurological correlations in the newborn. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.