![]() The halo sign was detected on ultrasound in 32 (91%) fetuses (23 in the second trimester and nine in the third), and it was an isolated sonographic finding in six of these cases, all in the second trimester. One fetus underwent intrauterine demise and TOP was carried out in 34 cases. Thirty-five CMV-infected fetuses were included in the study, of which 25 were diagnosed in the second and 10 in the third trimester. Brain damage was categorized into two stages (Stage I, mild Stage II, severe) according to the histopathological severity and progression of brain lesions. Ventriculitis was classified into four grades (Grades 0-3) according to the presence and extent of inflammation. Hematoxylin-eosin-stained histologic slides were reviewed independently by two experienced pathologists blinded to the neuroimaging results. An expert fetal radiologist reanalyzed magnetic resonance imaging (MRI) examinations when available, blinded to the ultrasound and histological results. Cases were classified according to whether the halo sign was the only CNS finding (isolated halo sign) or concomitant CNS anomalies were present (non-isolated halo sign). The halo sign was defined as the presence of homogeneous periventricular echogenicity observed in all three fetal brain orthogonal planes (axial, parasagittal and coronal). A maternal-fetal medicine expert reanalyzed the images from the transabdominal and transvaginal neurosonography scans, blinded to the histological findings. All included cases had been evaluated by conventional complete fetal autopsy. This was a retrospective study of fetuses diagnosed with severe CMV infection based on central nervous system (CNS) abnormalities seen on ultrasound, which had termination of pregnancy (TOP) or fetal demise at a single center from 2006 to 2021. ![]() To evaluate the correlation of periventricular echogenic halo (halo sign) with histopathological findings and its association with other brain imaging abnormalities in fetuses with cytomegalovirus (CMV) infection. 10 Diagnostic Imaging Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.9 Diagnostic Imaging and Image Guided Therapy, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.8 Institut de Recerca Sant Joan de Déu, Barcelona, Spain.7 Department of Anatomical Pathology, Hospital Sant Joan de Déu, Barcelona, Spain.6 Department of Pathology, Hospital Clínic, Barcelona, Spain.5 Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain.4 Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico. ![]()
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