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Antenatal diagnosis of iniencephaly: sonographic and MR correlation: a case report.

Pungavkar SA, Sainani NI, Karnik AS, Mohanty PH, Lawande MA, Patkar DP, Sinha S - Korean J Radiol (2007 Jul-Aug)

Bottom Line: However, the details of the fetal brain and spinal cord may not be adequately delineated on US.We found MR imaging to be superior for depicting central nervous system abnormalities.MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.

View Article: PubMed Central - PubMed

Affiliation: Department of MRI, Mammography and BMD, Balabhai Nanavati Hospital & Research Centre, S.V. Road, Vile Parle (West), Mumbai, INDIA. drsonap@yahoo.co.in

ABSTRACT
Iniencephaly is an uncommon and fatal neural tube defect involving the occiput and inion, this occurs together with rachischisis of the cervical and thoracic spine, and retroflexion of the head. We report the ultrasound (US) and magnetic resonance (MR) imaging findings of a case of iniencephaly with clubfeet and arthrogryposis. The diagnosis of iniencephaly is easy to make on ultrasound due to the typical star-gazing fetus. However, the details of the fetal brain and spinal cord may not be adequately delineated on US. We found MR imaging to be superior for depicting central nervous system abnormalities. MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.

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MR image reveals the normal supratentorial brain of fetus II, except for mild unilateral colpocephaly (white arrow).
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Figure 5: MR image reveals the normal supratentorial brain of fetus II, except for mild unilateral colpocephaly (white arrow).

Mentions: Fetal MR was performed on a 1.5 Tesla MR scanner (Signa, GE Echospeed, Milwaukee, WI) for further evaluation after obtaining an informed consent. Single-shot fast spin-echo sequences (ssFSE; TR/TE- 1392/95) and a body coil were used. MR examination revealed two fetuses. The twins were separated by a thin hypointense membrane, which was difficult to visualize. Fetus I was normal, fetus II had a brachycephalic skull and hyperextended short neck. For fetus II, the supratentorial brain parenchyma was normal. The lateral and third ventricles were normal in size and shape, except for mild unilateral colpocephaly (Fig. 5). The fourth ventricle was enlarged and it communicated with the cisterna magna (Figs. 6, 7). The brainstem from the level of the pons was split into two symmetrical halves. This split extended caudally beyond the cervicomedullary junction into the upper portion of the cervical cord (Figs. 6, 7). The spinal canal in this region was widened (Fig. 8); however, there was no bony spur. Distally, the spinal cord appeared normal in shape and thickness (Fig. 8). No split could be identified in the vertebral column. The knees were extended. Both feet demonstrated talipes equinovarus deformity (Fig. 4). Two placentae were identified; one was anterior, while the other was posterior and fundal. Both the umbilical cords had three vessels. The cervix was short and effaced.


Antenatal diagnosis of iniencephaly: sonographic and MR correlation: a case report.

Pungavkar SA, Sainani NI, Karnik AS, Mohanty PH, Lawande MA, Patkar DP, Sinha S - Korean J Radiol (2007 Jul-Aug)

MR image reveals the normal supratentorial brain of fetus II, except for mild unilateral colpocephaly (white arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627161&req=5

Figure 5: MR image reveals the normal supratentorial brain of fetus II, except for mild unilateral colpocephaly (white arrow).
Mentions: Fetal MR was performed on a 1.5 Tesla MR scanner (Signa, GE Echospeed, Milwaukee, WI) for further evaluation after obtaining an informed consent. Single-shot fast spin-echo sequences (ssFSE; TR/TE- 1392/95) and a body coil were used. MR examination revealed two fetuses. The twins were separated by a thin hypointense membrane, which was difficult to visualize. Fetus I was normal, fetus II had a brachycephalic skull and hyperextended short neck. For fetus II, the supratentorial brain parenchyma was normal. The lateral and third ventricles were normal in size and shape, except for mild unilateral colpocephaly (Fig. 5). The fourth ventricle was enlarged and it communicated with the cisterna magna (Figs. 6, 7). The brainstem from the level of the pons was split into two symmetrical halves. This split extended caudally beyond the cervicomedullary junction into the upper portion of the cervical cord (Figs. 6, 7). The spinal canal in this region was widened (Fig. 8); however, there was no bony spur. Distally, the spinal cord appeared normal in shape and thickness (Fig. 8). No split could be identified in the vertebral column. The knees were extended. Both feet demonstrated talipes equinovarus deformity (Fig. 4). Two placentae were identified; one was anterior, while the other was posterior and fundal. Both the umbilical cords had three vessels. The cervix was short and effaced.

Bottom Line: However, the details of the fetal brain and spinal cord may not be adequately delineated on US.We found MR imaging to be superior for depicting central nervous system abnormalities.MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.

View Article: PubMed Central - PubMed

Affiliation: Department of MRI, Mammography and BMD, Balabhai Nanavati Hospital & Research Centre, S.V. Road, Vile Parle (West), Mumbai, INDIA. drsonap@yahoo.co.in

ABSTRACT
Iniencephaly is an uncommon and fatal neural tube defect involving the occiput and inion, this occurs together with rachischisis of the cervical and thoracic spine, and retroflexion of the head. We report the ultrasound (US) and magnetic resonance (MR) imaging findings of a case of iniencephaly with clubfeet and arthrogryposis. The diagnosis of iniencephaly is easy to make on ultrasound due to the typical star-gazing fetus. However, the details of the fetal brain and spinal cord may not be adequately delineated on US. We found MR imaging to be superior for depicting central nervous system abnormalities. MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.

Show MeSH
Related in: MedlinePlus