An article for medical students and non-medical students to have a reference for.

1. OP No. : 14
Correlationof UltrasoundandMagnetic
ResonanceImagingforFetal CNSAnomalies .
Presenting author -Dr Akshay S Kadam (Patil)
Co –author – Dr Dev Shetty Prof & Head of Department ;
Dr Neha A Kadam (Patil)

2. Congenital malformation is a stimulating problem for research study because
of the high frequency of its occurrence and the devastating effect it may
have on the individual and his family.
Introduction:

3.  Ultrasound has made substatntial contribution for prenatal
diagnosis of congenital anomalies.
 Ultrasound is the primary modality used to assess the fetus.
 Ultrasound examination by a skilled operator, in most cases,
provides adequate information regarding fetal morphology, its
environment, and its well-being.
 The abnormalities detected on Ultrasound may at times be very
subtle or inconclusive. In such cases, several studies have shown
that MRI is a helpful modality.

4.  Magnetic resonance imaging (MRI), provides a highly accurate
depiction of the morphological changes of development in the
normal brain and in fetal brain disorders.
 MRI can provide improved anatomical resolution, Another advantage
of MRI is that intracranial brain imaging is not impacted by the
calvaria, which allows clear identification of the cortex and
subarachnoid space.
 Moreover, prenatal US has a limited specificity in diagnosis of fetal
anomalies.
 The potential application of MRI as an alternative to Ultrasound has
its advantages and limitations . Fetal motion was a limiting factor in
early studies however; the fast MRI sequences subsequently
can obtain images required for diagnosis.
.

5.  MRI is a useful supplement to Ultrasound for the assessment of
fetal brain malformations.
 Superior soft tissue contrast , and the ability to depict sulcation and
myelination are the strengths of MRI.
 Fast T2W, BTFE sequences form the basis of fetal MRI.
 There have been no reports of deleterious effects of MRI on the
fetus .

6. SEQUENCES
 T2W AXIAL
 T2 CORONAL
 BTFE
 SSFSE

7. Aims and objectives:
TO COMPARE EFFICACY OF USG AND MRI IN DETECTING FETAL
CNS ANOMALIES.
FOR BETTER EVALUATION AND MANAGEMENT OF FETAL CNS
ANOMALIES.

8. MATERIALS AND METHODS :
 Samsung RS 80A Ultrasound machine.
 MRI imaging of these patients will be performed on a “PHILIPS
ACHIEVA 1.5 T MRI MACHINE”, at the Radio-diagnosis
Department

9.  1)INCLUSIONCRITERIA:
 1. All pregnant women with suspected fetal anomaly on
Ultrasound scan and above 18 years of age.
 2. Pregnant women with previous history of fetal congenital
anomalies.
 3. Pregnant women with confirmed diagnosis of congenital
anomalies of fetus in utero who are less than 20 weeks .
 2) EXCLUSIONCRITERIA:
 1. Pregnant women having a history of claustrophobia
 2. Pregnant women having a history of metallic implants
insertion, cardiac pacemakers and metallic foreign body in
situ.
 3. Pregnant women who require sedation

10. Cavum septum vergae
26 Weeks old with Cavum pellucidum and vergae

11. Cavum septum vergae
There is a large CSF collection
between leaves of septum
pellucidum . Typical appearance of
Cavum septum pellucidum with
Cavum Vergae .

12. lissencephaly
20 Weeks old had smooth frontoparietal brain surface

13. lissencephaly
20 Weeks old Thick cortex is seen in Bilateral Frontoparietal region with
Broad Gyri

14. Holoprosencephaly
22 Weeks old with fusion of Lateral horn of Frontal ventricles with
fused Thalami & Absent septum pellucidum.

15. Dandy Walker Malformation
19 Weeks old
Posterior fossa appears
enlarged with Lambdoid
inversion.
Cystic dilatation of fourth
ventricle.
Hypoplasia of cerebellar
vermis is seen.

16. Anencephaly
19 Weeks old on USG Absent Skull Vault

17. Anencephaly
Absent cortical tissue and skull
vault with frog eye appearance

18. FROG EYE SEEN WITH ABSENT NEUROPARENCHYMA
AND SKULL VAULT

19. Persistently wide open mouth with a unilateral
facial cleft extending from left angle of mouth
to left ear
2D USG CORONAL 3D USG
RETROGNATHIA.
2D USG PROFILE VIEW
Colpocephaly with Facial Cleft

20. FACIAL CLEFT EXTENDING FROM LEFT ANGLE OF
MOUTH TO LEFT EAR
FETAL MRI
CONSECUTIVE CORONAL SECTIONS

21.  Moderate Hydrocephalus
with colpocephaly with dysgenesis of corpus callosum
 Retrognathia
FETAL MRI

22. ABORTUS
FACIAL CLEFT

23. THANK YOU