Fig 3.

MR imaging of the brain and the spinal cord of an infant with microcephaly probably caused by congenital Zika virus infection, who has arthrogryposis. Sagittal T2-weighted image (A) shows craniofacial disproportion, a hypogenetic corpus callosum (short black arrow), pons hypoplasia (white arrow), and a slightly enlarged cisterna magna (long black arrow). Note the lush external occipital protuberance (star). Axial T2-weighted image (B) shows an extremely simplified gyral pattern, a thin cortex with minimal sulcation, enlargement of the subarachnoid space (stars), and severe ventriculomegaly, mainly at the posterior horn (black arrows). Note small dystrophic calcifications, mainly at the basal ganglia and thalamus and in the junction between the cortical and subcortical white matter, and periventricular calcifications (black arrows) on T2-weighted SWI (C and D). Sagittal T2-weighted volumetric GRE (E) shows reduced spinal cord thickness, especially in the thoracic region (white arrows). On the axial reconstruction of T2-weighted volumetric GRE (F–H), we can observe reduction of the conus medullaris anterior roots (long arrows) compared with the posterior roots (short arrows), suggesting increased damage in the anterior-versus-posterior horns of the spinal cord. Coronal T2-weighted imaging (I) reveals congenital hip dysplasia, especially on the right side (white arrow).