Head Ultrasound or MRI? The Role of Neuroimaging in the Assessment of Symptomatic and Asymptomatic Infants with Congenital CMV Infection
Bibliographic record
Abstract
Despite interest in universal screening for congenital CMV infection (cCMV), there is little consensus on the management of asymptomatic newborns, and on the role or type of neuroimaging to be performed in infected infants. The objective of this study was to assess the concordance between head ultrasound (US) and magnetic resonance imaging (MRI) in identifying neurological abnormalities in infants with cCMV infection. Retrospective review of infants with cCMV infection, referred to the Centre Maternel Infantile d’Infectiologie Congenitale at Sainte-Justine Hospital Center in Montreal, between 2008 and 2016. This was a secondary analysis of a previous study and included only patients who underwent baseline CMV qPCR and had neuroimaging records available. Of 46 cases of cCMV infection, 10 were categorized as clinically asymptomatic, and were identified following maternal seroconversion during pregnancy (8) or during targeted screening of HIV exposed newborns (2). Twenty-eight patients had US followed by MRI, 4 underwent US followed by CT (3) or CT and MRI(1), and 11 had only 1 imaging modality (US, CT, or MRI). Among cases with sequential US and MRI, US was performed at a mean of 13 days (SD ±19) and MRI at a mean of 70 days of age (SD ±164). In 20/28 cases, US and MRI were concordant (9 abnormal, 11 normal). In 4 cases, US was normal and MRI later found to be abnormal; however in these 4 cases patients were clinically symptomatic and the initial imaging findings did not influence the decision to treat. In 4 cases, US was abnormal and subsequent MRI found to be normal; in 2 of these cases, patients were clinically symptomatic and the imaging findings did not influence the decision to treat. However, in 2 cases, the patients were clinically asymptomatic and categorized as symptomatic for treatment based only on the abnormal US findings. In this study, there was a discordance between MRI and US findings in 29% of infants with cCMV infection. While the addition of MRI to baseline head ultrasound did not influence the decision to treat in clinically symptomatic infants, the addition of MRI for infants with abnormal head US who are clinically asymptomatic could help refine treatment decisions in these cases. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".