Rana Abhilasha,  Mansfield Kori,  Radder Shrinivas,  Razzaq Sania,  Jayappa Sateesh,  Charles Glasier,  Ramakrishnaiah Raghu,  Murphy Janice

Final Pr. ID: Poster #: CR-017

Meroanencephaly is an extremely rare open neural tube under anencephaly spectrum with midline superior calvarial defect, herniation of disorganised brain parenchyma through the defect with deficient overlying skin. Anencephaly has an incidence of 0.1% on antenatal ultrasound, meroanencephaly is even rarer accounting for 3.4% cases of anencephaly. MRI is the modality of choice for complete assessment of meroanencephaly and antenatal ultrasonographic findings should be confirmed with fetal MRI.
A 35-year-old female presented for fetal MRI after suspicion of occipital encephalocele on antenatal ultrasound. MRI showed microcephaly with thin and abnormally shaped calvarium, a midline calvarial defect in the region of vertex with brain parenchyma protruding through the defect and deficient overlying skin covering. Meningeal covering was difficult to assess due to oligohydroamnios and close apposition of skull to uterine wall. There was absence of ventricular system and lack of normal supratentorial and infratentorial anatomical landmarks. Fetal face was normal. Persistent fetal thoracic kyphotic curvature was observed throughout the examination, spinal cord and spinal canal were normal with no spinal dysraphism. No other anomalies were demonstrated. Read More

Authors:  Rana Abhilasha , Mansfield Kori , Radder Shrinivas , Razzaq Sania , Jayappa Sateesh , Charles Glasier , Ramakrishnaiah Raghu , Murphy Janice

Keywords:  Fetal Magnetic Resonance Imaging, Brain, Congenital

Rana Abhilasha,  Mansfield Kori,  Radder Shrinivas,  Razzaq Sania,  Jayappa Sateesh,  Charles Glasier,  Ramakrishnaiah Raghu,  Murphy Janice

Final Pr. ID: Poster #: EDU-028

Dandy-Walker continuum is a group of posterior-fossa malformations which presents as posterior-fossa cyst with variable degree of vermian hypoplasia on antenatal ultrasound. However, evaluation of posterior fossa is limited on antenatal ultrasound. Fetal MRI provides excellent evaluation of posterior fossa including cerebellar vermis and biometric measurements for accurate characterization of Dandy-Walker Continuum which includes classic Dandy-Walker malformation, Vermian hypoplasia, Blake pouch cyst and Mega cisterna magna (in the order of severity).
In this pictorial review we will provide a step-wise approach for accurate characterization of Dandy-Walker continuum on fetal MRI through various case-based illustrations, biometric measurements (tegmentovermian angle, vermian and lateral ventricle size) and position of 4th ventricle choroid plexus. Associated findings like ventriculomegaly, corpus callosal agenesis, cortical migrational anomalies will also be demonstrated. This will aid pediatric radiologists in providing accurate antenatal diagnosis of Dandy-Walker continuum which is helpful for post-natal management as severe cases require immediate shunting and milder cases require only follow-up. Read More

Authors:  Rana Abhilasha , Mansfield Kori , Radder Shrinivas , Razzaq Sania , Jayappa Sateesh , Charles Glasier , Ramakrishnaiah Raghu , Murphy Janice

Keywords:  Fetal Magnetic Resonance Imaging, Dandy-Walker Continuum, Neuroradiology

Kazelka Maryam,  Shao Lei,  Mcgraw Marty,  Neville Kucera Jennifer

Final Pr. ID: Poster #: CR-016

Spindle cell sarcomas are a rare and aggressive type of soft-tissue sarcoma. Although rhabdomyosarcomas are the most common childhood sarcoma, the spindle cell type is incredibly rare. A 25-year-old healthy G2P1001 female presents at 34 weeks gestational age with fetal growth restriction of a male fetus. Prenatal ultrasound showed a complex vascular mass exophytic to the distal spine, with a presumed diagnosis of sacrococcygeal teratoma (SCT). For further characterization, a fetal MRI was performed at 35 weeks gestation, which showed a solid appearing mass exophytic to the pelvis and involving the proximal thigh. Many features of the tumor were atypical for sacrococcygeal teratoma: the mass being more homogenous than expected, lacking cystic components that would normally been seen in a SCT, and involving the thigh but without definite involvement of the spine. It was also noted that the normal T1 meconium signal in the rectum was displaced posteriorly by the mass. At that time, an alternative differential diagnosis was suggested: sarcoma including fibrosarcoma or rhabdomyosarcoma, myofibroma, or less likely atypical sacrococcygeal teratoma. The baby was born via C-section at 37 weeks and 1 day gestation. A postnatal MRI showed the mass exophytic to the pelvis with some intrapelvic extension via the inguinal canal. Lack of spine involvement was confirmed. Signal characteristics of the tumor were similar to that of skeletal muscle, with a few focal areas of internal hemorrhage. The tumor had mass effect on multiple structures: deviating and tethering of the rectum to the right and stretching it inferiorly; displacing the anus posteriorly; uplifting the bladder; and abutting the base of the penis with no clear fat planes. Surgical resection was performed when the baby was 6 days old. Pathology evaluation revealed a sarcoma that was diffusely infiltrative with NTRK reactivity by immunohistochemistry. Molecular studies by next-generation sequencing reported TPM3-NTRK1 fusion in the tumor. Pathology was most suggestive of a spindle-cell sarcoma. It is important for the pediatric radiologist to be familiar with fetal soft tissue tumors to help facilitate family counseling and delivery planning. The radiologist should understand imaging features that may help distinguish more rare soft tissue tumors from sacrococcygeal teratomas. Although an exact diagnosis may not be possible prenatally, a multidisciplinary approach ensures the best possible patient outcomes. Read More

Authors:  Kazelka Maryam , Shao Lei , Mcgraw Marty , Neville Kucera Jennifer

Keywords:  Sarcomas, Fetal Magnetic Resonance Imaging, Soft Tissue Sarcoma

Gwal Kriti,  Malik Archana,  Neville Kucera Jennifer,  Saul David

Final Pr. ID: Poster #: CR-013

To present an extremely rare case of fetus in fetu which was discovered with prenatal ultrasound and fetal MR. Read More

Authors:  Gwal Kriti , Malik Archana , Neville Kucera Jennifer , Saul David

Keywords:  Fetal Imaging, Fetal Magnetic Resonance Imaging, Prenatal Imaging