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  • 1. ADVANCED USG LOUNGESPIRAL CT MRI PET-CTCENTRE SEC 44 –CCHANDIGARHwww.spiralctmricentre.comDr Arun GuptaDirector imagingDr Rakhee guptaDr R K S GandhiDr Vinayak MittalDr Ritesh Mahajan
  • 2. SONO EMBRYOLOGY
  • 3. SONO EMBRYOLOGY VITTELOINTESTINAL DUCT
  • 4. VITELLOINTESTINAL DUCT /YOLK STALK OMPHALOMESENTERIC DUCT The endodermalconnection between the mid-gut and the yolk sac. During embryonic disc folding (humanweek 3) this structure is embroy Yolk sac initially a broad openconnection which is then restricted to a narrowtube and finally closed between the mid-gut and the yolk sac.
  • 5. YOLK SAC ATTTACHED TO EMBROY THROUGH VITTELOINTESTINAL DUCT
  • 6. The constituents of the vitelline duct  vitelline veins ( Paired)  (omphalomesenteric vein,The blood vessels which form in the yolk sac and have a blood flow towards the embryo. Derived from the extra-embryonic mesoderm surrounding the endoderm of the yolk sac.  vitelline arteries ( Paired) .  (omphalomesenteric artery The blood vessels which form in the yolk sac and have a blood flow away from embryo. Derived from the extraembryonic mesoderm surrounding the endoderm of the yolk sac.  Vitellogenesis  The term refers to the formation of yolk.
  • 7. Doppler values of Vitelline artery  Low velocity  No diastolic flow  PSV : 5.8 +_1.7cm/sec  PI : 3.24 +_.94
  • 8. 3D Rendered image
  • 9. Fetal anomaly series ……….. ARACHNOID CYST
  • 10. Arachnoid cyst …..a brief Arachnoid cysts are benign intracranial non communicating collections in the arachnoid memberane. USUALLY STABLE CAN OCCUR INTRACRANIALLY OR IN SPINAL CANAL ALSO. EVEN IF LARGE ( RARELY CAUSE SYMPTOMS)  MID LINE CYSTS MAY LEAD TO PITUITARY DYSFUNCTION.  MAY INTERFERE WITH CSF CIRCULATION. COMMON LOCCATIONS ARE : 1. SYLVIAN FISSURE / TEMPORAL FOSSA 2. POSTERIOR FOSSA 3. ALONG CEREBERAL CONVEXITY 4. MIDLIINE ( SUPRASELLAR)
  • 11. ARACHNOID CYST ………….FETAL MR IMAGECSF SIGNAL LARGECYSTIC LESION IN THELEFT TEMPORO-PARIETAL REGION( SYLVIAN FISSURECONFINES)/SUPRASELLAR / POSTERIORFOSSA REGION.( NEARLY OCCUPYING ALL THE COMMON SITES WHERE ARACHNOID CYST IS PRESENT )
  • 12. Fetal MR and Multiplanar USG Reformation.FETAL MR SAGITTAL IMAGE USG SECTIONAL PLANE IMAGINGMASS EFFECT IS APPRECIATED ON OF LARGE INTRACRANIAL CYSTBRAIN STEM INDENTATED ALONGTHE VENTRAL SURFACE
  • 13. Coronal images ….Fetal MR / USGNORMAL VERMIS / CEREBELLARHEMISHERE( RULES OUT DANDY- USG ( CORONAL PLANE )WALKER MALFORMATION)
  • 14. DIFFERENTIAL DIAGNOSIS FOR ARACHNOID CYST DEPENDS ON POSITION MIDLINE  Posterior fossa :  Cavum veli interpositi  Dandy walker  Aneurysm of vein of galen malformation ( Midline cysts may  Inferior vermian accompany corpus hypoplasia callosum dysgenesis  Mega cisterna magna so in supratentorial cysts corpus callosum  Blake’s pouch cysts should be assessed) .
  • 15. ReferencesDiagnostic Ultrasound4th EditionCarol M. RumackStephanie R. WilsonJ. William CharboneauDeborah Levine