Purpose or Case Report: The purpose of this educational exhibit is to educate the radiologist regarding the fetal and postnatal imaging findings of Zika Virus (ZikV) in order to include congenital ZikV in the differential diagnosis when the maternal history and geography are compatible. We present a patient who emigrated from Central America during her third trimester of pregnancy with maternal ZikV.
Methods & Materials: Key imaging features are demonstrated by prenatal ultrasound and fetal and postnatal magnetic resonance imaging (MRI).
Results: Recently, there has been an increase in reported epidemic outbreaks of the ZikV, a mosquito borne virus, in South and Central America as well as the Caribbean. Congenital Zika Virus is associated with fetal microcephaly and severe brain malformation. The imaging features of ZikV demonstrate microcephaly, cortical migration abnormalities (pachygyria/polymicrogyria), coarse calcifications at the junction of the cortical and subcortical white matter, and callosal abnormalities. These features share significant overlap with the other transplacentally acquired TORCH infections, namely CMV, Toxoplasmosis and Rubella. Cases of TORCH infections are provided for comparison in order to better delineate the unique imaging features of ZikV.
Conclusions: Congenital ZikV, as with other TORCH infections, has been associated with severe brain malformation and morbidity. As the prevalence of ZikV becomes more widespread, it is crucial for the radiologist to recognize the unique neuroimaging features associated with ZikV and consider it in the differential diagnosis for fetus’ and neonates with microcephaly and other congenital brain abnormalities.