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

Meeting name: SPR 2025 Annual Meeting , 2025

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

Keywords: Fetal Magnetic Resonance Imaging, Brain, Congenital

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

Meeting name: SPR 2025 Annual Meeting , 2025

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

Ultrasound is the initial modality for assessment of fetal anatomy. Fetal ventriculomegaly is detected in 1% of antenatal ultrasounds, further evaluation may be limited due to head position, acoustic shadow from skull bones and lack of contrast resolution. By overcoming these limitations fetal MRI plays an important role in diagnostic work-up of ventriculomegaly and aids in further characterization of associated anomalies. It is important for pediatric radiologists to be aware of various causes of ventriculomegaly, associated central nervous system and other anomalies as accurate antenatal diagnosis aids in determining further management (fetal surgery, mode of delivery, post-natal treatment). This educational exhibit will provide comprehensive review of role of fetal MRI in ventriculomegaly including fetal MRI sequences, broad spectrum of ventriculomegaly cases (rare syndromic cases- Neu Laxova, Aicardi syndrome; cebocephaly, holoprosencephaly, migrational anomalies, hydranencephaly, unilateral lateral ventriculomegaly, aqueductal stenosis, interhemispheric cyst, Chiari-2, intracranial hemorrhage), classification of ventriculomegaly (classified as developmental, obstructive and destructive with ex-vacuo ventricular dilatation) and associated anomalies (facial, spinal, limb, gastrointestinal, genitourinary). A comprehensive understanding of ventriculomegaly and associated anomalies on fetal MRI will aid the pediatric radiologists in arriving at accurate diagnosis. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

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

Keywords: Fetal MRI, Ventriculomegaly, Neuroradiology