WHITE-MATTER MR HYPERINTENSITIES IN ADULT PATIENTS WITH CONGENITAL-RUBELLA

PURPOSE: To observe and quantify white matter hyperintensities on MR i mages in adults with schizophrenialike symptoms who had had congenital rubella, in order to elucidate the neuropathologic sequelae of this p erinatal viral infection and to explore the potential relationship of these lesions to schizophrenia. METHODS: Eleven deaf adult patients wi th documented prenatal rubella virus infection and schizophrenialike s ymptoms were compared with 19 age-matched patients with early-onset sc hizophrenia who did not have congenital rubella and with 18 age-matche d control subjects. All MR images (obtained at 1.5 T) were evaluated b y a neuroradiologist who was blinded to diagnosis and were rated for w hite matter lesions on a five-point scale: 0 = no lesions; 1 = 1 lesio n less than 1 mm in diameter; 2 = 1 to 4 lesions 1 mm or greater; 3 = 5 to 10 lesions; 4 = more than 10 lesions or a single lesion more than 1 cm in diameter. In addition, the white matter hyperintensities were volumed objectively with a manual threshold technique. RESULTS: Ratin gs of white matter lesions were significantly higher in the rubella pa tients than in the control subjects: 6 of the 11 patients bad ratings greater than 1 compared with 1 of the 18 control subjects and none of the 19 schizophrenic patients. Also, MR images in five rubella patient s received ratings at the highest end of the scale of abnormality (3 o r 4). The white matter hyperintensities were characterized as bilatera l T2 signal hyperintensities in periventricular and subcortical region s, punctate or linear in shape; they were observed predominantly in pa rietal lobes. CONCLUSION: This quantitative MR study of adult rubella patients disclosed abnormal white matter lesions that may correspond t o neurovascular lesions known neuropathologically. They do not appear to be directly related to schizophrenialike symptoms.