Anencephaly

Dr Arun Gupta Director imaging

Dr Rakhee gupta Dr R K S Gandhi Dr Vinayak Mittal Dr Ritesh Mahajan

ANENCEPHALY

ANENCEPHALY

CHARACTERIZED BY

1. Absence of the

2. Cranial vault

3. Cerebral hemispheres

4. Diencephalic Structures.

These structures are replaced by a

flattened, amorphous Vascular-neural mass Area

Cerebro-vasculosa

Coronal view of fetusshows the spine ending in a clump of

amorphous vascular neural mass without a formed cranial vault .

TUI Tomographic USG imaging

Appreciate the spine ending in the skull base bones . No cranial vault bones .

Amorphous vascular neural mass appreciated over the skull base

Rendered image of the fetal orbits with absence of the normalFormed cranial bones .

Fetal orbits

Absence of the Cranial vault bones

Area cerebro vasculosa

An overview…………………..

Area cerebrovasculoa may resemble brain but there is always absence of the skin , cranial bones and brain above the orbits.

Facial structures and orbits are present .

Spine , Non CNS anomalies ,Polyhydramnios are usually associated .

Dysraphism may involve entire head/ spine ( Craniorachischisis )

Outcome of the anencephaly is invariably fatal and termination is offered at any age .

Eraly detection ( as early as 14wks ) . TVS examination with dedicated assessment of the frontal bones can be attempted for early detection but diagnosis of anencephaly should not be made before 10wks of gestation.

ANENCEPHALY

In early pregnancy area cerebro-vasculosa may resemble normal brain without bony covering ( exencephaly ) but as the pregnancy grows the brain is destroyed and becomes flattened as in anencephaly .

ANENCEPHALY

An overview…………………..

CORONAL VIEW

Fetal orbits appreciated .Appreciate

flattening of the

curvature above the

fetal orbits

FORMED BASAL SKULL BONES

POLYHYDRAMNIOS APPRECIATE THE Echogenic amniotic fluid caused by debris shed from the uncovered brain .

ANENCEPHALY : A B S E N C E O F T H EC R A N I A L VA U LT, C E R E B R A L H E M I S P H E R E S, A N D D I E N C E P H A L I C S T R U C T U R E S. T H E S E A R E R E P L A C E D BY A F L ATT E N E D, A M O R P H O U S VA S C U L A R - N E U R A L M A SS ( A R E A C E R E B R OVA S C U L O S A )

E X E N C E P H A LY : N O R M A L B R I A N U N C OV E R E D BY B O N E

C R A N I O R A C H I S C H I S I S : D Y S R A P H I C A B N O R M A L I T Y I N VO LV E S T H E H E A D A N D E N T I R E S P I N E

A C R A N I A : A B S E N C E O F T H E C R A N I A L VA U LT B O N E S O F T H E C A LVA R I U M

TERMINOLOGY

REFERENCE

DIAGNOSTICULTRASOUNDFOURTH EDITIONCarol M. Rumack, MD, FACRJ. William Charboneau, MD, FACRDeborah Levine, MD, FACR