1 / 28

Anomalies of the Posterior Fossa and the Spinal Cord- Fetal MRI

XIX SYMPOSIUM NEURORAGIOLOGICUM BOLOGNA OCTOBER 4-9, 2010. Anomalies of the Posterior Fossa and the Spinal Cord- Fetal MRI. Chen Hoffmann, MD Neuroradiology Sheba Medical Center, Israel Affiliated to Tel-Aviv University. Indications. Ventricular dilatation Ventricular asymmetry

liz
Download Presentation

Anomalies of the Posterior Fossa and the Spinal Cord- Fetal MRI

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. XIX SYMPOSIUM NEURORAGIOLOGICUM BOLOGNA OCTOBER 4-9, 2010 Anomalies of the Posterior Fossa and the Spinal Cord- Fetal MRI Chen Hoffmann, MD Neuroradiology Sheba Medical Center, Israel Affiliated to Tel-Aviv University

  2. Indications • Ventricular dilatation • Ventricular asymmetry • Malformations • Disease found in siblings in previous pregnancies • Vascular malformations • Infectious diseases

  3. Indications (cont’) • US is the first imaging of choice • When US is abnormal the MR is done to verify the diagnosis and to identify additional malformations • US can be suboptimal (head position) • Vermis is formed by 18 weeks GA

  4. Anomalies of the Posterior Fossa • Small PF (Chiari II) • Cystic anomalies (Dandy-Walker, arachnoid cyst, mega cisterna magna) • Others (rhombencephalosynapsis, Walker Warburg syn., vascular)

  5. Myelomeningocele + Chiari II © Erin S. Schwartz, CHOP

  6. Chiari II • Small PF • Downward herniation of cerebellum and brainstem • Cervicomedullary kink • 4th ventricle elongated with no posterior point • Open dysraphism (MMC) in 100%

  7. 22w GA: Chiari II & Myelomeningocele on US © Orit Glenn, UCSF Postnatal MRI: In Utero Repair

  8. Missed MMC • 33 weeks GA • Ventricular dilatation • Partial agenesis of corpus callosum • No associated anomalies known • After birth- MMC! • Only one image showed a cystic mass not in the midline

  9. Differential Diagnosis: Sacrococcygeal Teratoma

  10. Differential Diagnosis: Currarino Syndrome

  11. Suspected Chiari III

  12. Cranial Meningoencephalocele Post natal US axial sagital

  13. Cranial Meningoencephalocele Pre OP © Liat Ben Sira, TAMC

  14. Cranial Meningoencephalocele Post OP MR Post op PF Diastemat. Bone anomm.

  15. 22w GA: Lumbar spine bony anomaly on US © Orit Glenn, UCSF

  16. Postnatal MRI at one day of age confirms findings of fetal MRI Dx: segmental spinal dysgenesis

  17. Cystic Anomalies • Dandy walker malformation • Blake’s pouch • Arachnoid cyst • Mega cisterna magna

  18. Dandy-Walker Complex • Dandy-Walker Complex • Tentorium elevated • Posterior fossa is enlarged • Hypo genetic vermis and anti-clockwise rotated • Brainstem compressed

  19. Dandy-Walker Complex • The cerebellar hemispheres • are dysplastic • The 4th ventricle is opened to • the cisterna magna

  20. Blake’s Pouch • 22 weeks GA • Large PF • Lower part of the vermis is not formed • Posterior part of the 4th ventricle is open to the cisterna magna

  21. Arachnoid Cyst • A cystic lesion posterior to the cerebellum • Vermis is intact • A thin septum between the cyst and the cisterna magna

  22. Others

  23. Walker-Warburg Syn. Age of 1 week

  24. Rombencephalosynapsis • Fused cereballar hemispheres • Absent vermis • Absent primary fissure • Narrow 4th ventricle in Ax plane (key hole shape) • +/- septo-optic dysplasia

  25. 29w GA: Post. Fossa Mass on US, ? Subdural © Orit Glenn, UCSF

  26. 31w GA: Follow-up MRI Dx: dural sinus malformation

  27. Vein of Gallen Malformation A-V fistula between deep choroidal arteries and the median prosencephalic vein Of Markovski

  28. The Chaim Sheba Medical Center Tel Hashomer, Israel Chen.hoffmann@sheba.health.gov.il

More Related