Neuronal migration and cortical organization takes place primarily during the second trimester and early third trimester. Therefore, detection of cortical malformations and migrational anomalies on a fetal MRI in a maturing brain is difficult and may not be evident in some cases, if performed early. Familiarity with normal sulcation pattern in a fetus at various ages of gestation and a basic understanding of the embryogenesis of neuronal migration is essential to be able to make a diagnosis of these entities. <b>Goals of the exhibit </b> -Understand development of cerebral cortex and normal fetal MRI appearance at various stages of gestation. - Using this knowledge, be able to recognize various cortical malformations in a fetus and provide a comprehensive diagnosis regarding etiology, whenever feasible or when the appearance is typical or when there are ancillary findings - Avoid certain pitfalls and improve accuracy without overcalling or undercalling migrational anomalies in a fetal MRI <b>Outline of the exhibit</b> Embryology of neuronal migration (during second and third trimesters) Normal sulcation pattern during mid and late trimesters Etiology of neuronal migration and cortical malformations -Multifactorial - Infectious - Genetic mutation/chromosomal - Ischemic insult - Metabolic disorders like Zellweger <b>Appearance of various migrational anomalies and cortical malformations in a fetal brain</b> Polymicrogyria – subtle and extensive forms, appearance during various stages of gestation, correlation with post-natal imaging, typical appearance in certain genetic mutations, TORCH infections etc Schizencephaly – associations with absence of septum pellucidum and other abnormalities Gray matter heterotopia – How to differentiate from subependymal nodules and hemorrhage? Lissencephaly – How to identify a true lissencephaly/pachygyria in a developing brain with immature sulcal pattern? Hemimegalencephaly, Microcephaly with simplified gyral pattern and other cortical malformations <b>Evolution of cortical malformations on imaging</b> -Comparison between early and late gestation fetal MRIs in the same patient when available - Prenatal and post-natal MRI correlation of migrational anomalies, when available <b>Ancillary CNS and extra-CNS abnormalities identified in fetuses with migrational anomalies</b> <b>Pitfalls and false positive/ false negative cases and how to avoid them.</b> Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Ganapathy Shankar, Hunter Kyle, Janitz Emily, Sreedher Gayathri

Keywords: migrational anomalies, cortical malformations

The Society of Pediatric Radiology (SPR) has recognized the urgent need for improved education in neonatal imaging, especially given rapid advancements and innovation in imaging technology and techniques. This initiative is aimed at pinpointing specific areas within neonatal imaging that require enhanced outreach and training for physicians, ultimately to improve care for neonates. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Gwal Kriti, A Ebinesh, Ames Jeff, Dong Su-zhen, Lorenz Kevin, Hwang Misun, Barton Katherine, Birkemeier Krista, Shah Chetan, Verhage Thomas, Narayanan Srikala, Li Yi, Janitz Emily, Brown Brandon

Keywords: Education, Neonatal, Preterm Neonate