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ADVANCED USG LOUNGE
SPIRAL CT MRI PET-CT CENTRE SEC 44 –C CHANDIGARH
www.spiralctmricentre.com
Dr Arun Gupta Director imaging Dr Rakhee gupta Dr R K S Gandhi Dr Vinayak Mittal Dr Ritesh Mahajan
Fetal anomaly series ………..
SPINA BIFIDA
OPEN ( Not covered with skin) . Elevation of MS AFP , associated with intracranial changesCLOSED ( Covered with skin) . MSAFP Normal . No intracranial changes.
CRANIAL SONOGRAPHIC FEATURES OF THE SPINA BIFIDA
• Non visualization of cistern magna • Deformation of the cerebellum (Banana sign)• Concave frontal bones (Lemon sign)• Dilatation of the lateral ventricles (Ventriculomegaly)• Chiari II malformation.
LEMON SIGN
Bifrontal scalloping / indentation.
Concave deformity of the fetal frontal bones
SHOULD Prompt detailed examination of the spine and posterior fossa
Can be seen in Normal fetus to diverse deformities :
Encephalocele
Dandy walker malformation
Thanatophoric dysplasia
BANANA SIGN
Spinal dysraphism leads to CSf leak and low intracranial pressure . This leads to effacement of the posterior fossa and cerebellum accommodates to the small space . The cerebellum wraps around the brain stem and appears as BANANA on transaxial scans .
CHIARI MALFORMATION
EFFACEMENT OF THE CISTERNA MAGNA
CAUDAL PLACEMENT OF THE CEREBELLUM
OBLITERATION OF CISTERNA MAGNA
EFFACEMENT OF THE CISTERNA MAGNA
SMALL CEREBELLUM WITH REDUCED TRANCEREBELLAR
DIAMETRE
VENTRICULOMEGALY
Due to prominent ventricles
The dependant Choroid plexus appears drooping /dangling .
DEFICIENT CENTRUM OSSIFICATION IN SACRUM
Diagnostic Ultrasound 4th EditionCarol M. RumackStephanie R. WilsonJ. William CharboneauDeborah Levine
REFERENCE