Fetal-Brain

A free gallery of high-resolution, ultrasound, color doppler and 3D images

Ultrasound images of anomalies of the fetal brain:

1) Dandy-Walker malformation:

Sonography in Dandy-Walker syndrome:

The above ultrasound images of fetal brain show hypoplastic cerebellum and absent vermis with enlarged 4th ventricle which is typical of Dandy-Walker malformation. Images courtesy of Dr. Gidda Ramaiah, India. (Note: click to view larger images).

Reference: 1) http://www.emedicine.com/radio/topic206.htm (free)

2) Herniated Dandy-Walker cysts, Prenatal Diagnosis (free article)

2) Aneurysm of Vein of Galen:

Ultrasound images of intracranial venous aneurysm in fetus:

These are ultrasound images of a 30 week old fetus. Sonography of the fetal brain reveals an anechoic (cystic) lesion posterior to the thalamus and the midbrain. Color doppler image reveals significant flow within this lesion. These ultrasound images are diagnostic of aneurysm of the Vein of Galen. Vein of Galen aneurysms are usually diagnosed in the 3rd trimester. They are usually produced by draining of multiple arteriovenous malformations in the adjacent part of the fetal brain. Differential diagnosis of such lesions includes arachnoid cysts (easily diagnosed using color doppler imaging).

Images courtesy of Dr. Anita Kaul, Delhi, India.

3) Acrania:

This 12 week fetus shows prolapse of the brain outside the cranial cavity with absence of the cranial vault (calvarium). The brain is almost normal in size for this gestational age. These ultrasound images are diagnostic of acrania. This has to be distinguished from anencephaly, where the brain is absent or grossly atrophic. The colored pictures show 3D ultrasound images of the fetus. Images taken using a Medison SA 8000, color doppler and 3D ultrasound machine, courtesy of Dr. Arun Mahajan, Delhi, India.

Reference: http://www.thefetus.net/page.php?id=77 (free article and images)

4) Choroid plexus cyst:

Sonography of the fetal brain revealed a cystic lesion of 9 mm., in the choroid plexus of the left lateral ventricle. These ultrasound images suggest choroid plexus cyst. Images taken using a Nemio-XG color doppler machine. Clinically, isolated choroid plexus cysts without the presence of associated fetal anomalies have little significance (see link below) and are known to resolve spontaneously.

Reference: 1) significance of choroid plexus cysts (free article- rated excellent).

2) Choroid plexus cysts and Trisomy 21 (free abstract)

5) Occipital meningocele with encephalocele:

Sonography of the fetal head showed-a) a small skin covered herniation of meninges through a small defect in the occipital region of the skull. b) presence of part of brain tissue in the herniated sac. The 3rd image shows the sac floating in the amniotic fluid. These ultrasound images suggest a diagnosis of occipital meningocele with encephalocele.

Images courtesy of Gunjan Puri, MD, Surat, India. He used a Toshiba Xario machine for these images.

Reference: http://drjoea.googlepages.com/obstetric-3 (visit this page for free ultrasound images and links for this fetal anomaly)

6) Aqueductal stenosis causing obstructive hydrocephalus:

Sonography of the fetal brain done on this 3rd trimester fetus shows marked dilatation of the lateral ventricles bilaterally. The 3rd ventricle and upper part of the cerebral aqueduct or aqueduct of Sylvius are also dilated. The choroid plexus on both sides (within the lateral ventricles) appear to "dangle" or droop to the dependent part of the brain. The lateral ventricles measure more than 30 mm. (3 cms.) on both sides at the level of the atria. The cerebral hemispheres show marked thinning of the cerebral tissue (both cortex and white matter), but are visualized as thin tissue along the cranial vault. Current literature holds that any fetal lateral ventricular measurement of more than 10 mm. (at the atria) is pathological. These ultrasound images suggest a diagnosis of aqueductal stenosis with intraventricular obstructive hydrocephalus. (Ultrasound images taken with GE Voluson machine are courtesy of Dr. Martin Horenstein, MD, Argentina).

The main criteria used to diagnose hydrocephalus/ ventriculomegaly are: 1) atrial size (greater than 10 mm.) 2) Ventricle to cerebral hemisphere ratio ( normal ranging from 74 % at 16 weeks to 35 % by 25 weeks). 3) The combined anterior horn width (normal = less than 20 mm.).

I have a short ultrasound video clip of aqueductal stenosis posted here:

http://cochinblogs.blogspot.com/2009/08/hydrocephalus-in-fetus-aqueductal.html

Reference: http://emedicine.medscape.com/article/1135286-overview

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This page was last edited on: Thursday December 17, 2009 12:49 PM

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