Experts present imaging findings to detect Zika abnormalities

In this Jan. 18, 2016, file photo, a female Aedes aegypti mosquito, known to be a carrier of the Zika virus, acquires a blood meal on the arm of a researcher at the Biomedical Sciences Institute of Sao Paulo University in Sao Paulo, Brazil.
Associated Press / Andre Penner, File

The D.C.-based Pan American Health Organization says experts from the Americas, including the Caribbean, have been discussing the crucial role of obstetric ultrasound in the screening and monitoring of abnormalities associated in pregnant women with confirmed Zika virus infection.

The organization said the panel of experts talking about radiology included Dr. Andrea Poretti and Dr. Thierry A.G.M. Huisman, experts in congenital brain anomalies from Johns Hopkins University; Dr. Jonel Di Muro from the Hospital Luis Razzetti of Venezuela; Priscilla Butler from the American College of Radiology; and Dr. Adriano Hazin from the Instituto de Medicina Integral; and Professor Fernando Figueira in Recife, Brazil.

The group said Zika virus disease is caused by a virus transmitted primarily by Aedes mosquitoes, and its symptoms include fever, skin rash, conjunctivitis, muscle and joint pain, malaise, or headache.

It added there is scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barré syndrome.

Links to other neurological complications are also being investigated, the group said.

To date, the health organization said 47 countries and territories in the Americas have confirmed autochthonous, vector-borne transmission of Zika virus disease since 2015, and five countries in the Americas have reported sexually transmitted Zika cases.

The group said obstetric sonography is the primary tool it recommends for screening and monitoring of fetal/neonatal brain abnormalities associated with the Zika virus.

“Although ultrasonography is a safe technology, it is user reliant and requires an extensive knowledge in maternal-fetal anatomy, acquisition and interpretation of images,” according to the organization.

It said pregnant women can be infected with Zika virus in any trimester, “which has caused increasing concern for maternal-fetal transmission of the virus.”

Structural brain anomalies, such as microcephaly, intracranial calcifications, ventriculomegaly, and malformation of cortical development, have been reported in many babies with congenital Zika virus infection.

It said panelists focused on the spectrum of neuroimaging findings that may be seen in children with congenital Zika virus infection, the crucial role and use of ultrasonography in the screening and monitoring of abnormalities associated with the Zika virus, and the appropriateness of the use of other neuroimaging techniques such as magnetic resonance imaging and computed tomography.

In some cases, PAHO said other technologies, such as Magnetic Resonance Imaging, have been used in addition to obstetric sonography.

The health organization said MRI provides more detailed information about the brain anatomy than ultrasonography, and can clarify unclear ultrasonography findings and when more details about the fetal-neonatal brain anatomy are needed.

“MRI is not as readily available as ultrasonography, however, and tends to be costly,” it said.

Latin America and the Caribbean face a gap in radiology services, according to experts.

“The availability and quality of services are often minimal or even unavailable, and some services have non-functional equipment, fail to practice quality control and assurance, or need more training for their staff,” the group said.

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