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Neuro-imaging in cCMV infection: let’s try and speak the same language

Pediatric Research (2025)Cite this article

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We read, with great interest, the review by Swanson et al.1 The authors provided a lot of new information and insights into asymptomatic congenital cytomegalovirus (cCMV) infection. They made us aware of new terminology, using ‘clinically inapparent cCMV infection (CICMV)’ in contrast to ‘clinically apparent cCMV infection (CACMV)’. The part on pathogenesis is especially of great interest.

We do however, have some concerns about the legend of Fig. 2, showing cranial ultrasound (cUS) images and corresponding MRI from three patients. It is really important that we speak the same language when reporting on imaging abnormalities in cCMV infection. In spite of several articles on this very topic, there is apparently still no agreement, especially when it comes to cUS findings.2

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Fig. 1: Imaging findings typically seen with cranial ultrasound in infants with cCMV infection.
Fig. 2: MRI findings in infants with cCMV infection.

References

  1. Swanson M. R., Haisley L. D., Dobyns W. B., Schleiss M. R. Beyond hearing loss: exploring neurological and neurodevelopmental sequelae in asymptomatic congenital cytomegalovirus infection. Pediatr. Res. https://doi.org/10.1038/s41390-025-04232-5 (2025).

  2. de Vries, L. S. Viral infections and the neonatal brain. Semin Pediatr. Neurol. 32, 100769 (2019).

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  5. Keymeulen, A. et al. Cranial ultrasound and MRI: complementary or not in the diagnostic assessment of children with congenital CMV infection?. Eur. J. Pediatr. 181, 911–920 (2022).

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  6. Blázquez-Gamero, D. et al.  Spanish Registry of Infants with Congenital Cytomegalovirus Infection (REDICCMV) Study Group. Role of Magnetic Resonance Imaging and Cranial Ultrasonography in Congenital Cytomegalovirus Infection.  Pediatr. Infect Dis. J. 38, 1131–1137 (2019).

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Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, the Netherlands

    Linda S. de Vries & Sylke J. Steggerda

  2. Neonatal Brain Group, Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain

    Ana Alarcon

  3. Department of Neonatology, Hospital Sant Joan de Déu and Hospital Clínic, Barcelona Centre for Maternal, Foetal and Neonatal Medicine (BCNatal), Barcelona, Spain

    Ana Alarcon

  4. Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain

    Ana Alarcon

Authors
  1. Linda S. de Vries
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  2. Sylke J. Steggerda
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  3. Ana Alarcon
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Contributions

L.S.V. conceptualised and drafted the correspondence and approved the final version to be published. S.J.S. critically reviewed the article and approved the final version to be published. A.A. critically reviewed the article and approved the final version to be published.

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Correspondence to Linda S. de Vries.

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de Vries, L.S., Steggerda, S.J. & Alarcon, A. Neuro-imaging in cCMV infection: let’s try and speak the same language. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04407-0

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