Cranial and cerebral signs in the diagnosis of spina bifida between 18 and 22 weeks of gestation: a German multicentre study

Abstract

In standard measuring planes, lemon sign, banana sign and an inability to image the cistern magna are very reliable indirect ultrasound markers of spina bifida. © 2014 John Wiley & Sons, Ltd.

Chiari malformations: principles of diagnosis and management

“…Ultrasonography is 97% sensitive and 100% specific for spina bifida 26. Open spina bifida may be detected on the dating scan at 12 weeks,27 but the structural cranial features of CM2 are more reliably detected at the anomaly scan at 20 weeks 28. These features include the classic “lemon sign” (bilateral scalloping of the frontal bones) and “banana sign” (a rounded cerebellum with obliterated cisterna magna).…”

Pränatale Diagnostik fetaler Neuralrohrdefekte

“…Die Sensitivität der beiden Marker "Lemon-Sign" und "Banana-Sign" ist sehr gut und liegt sowohl in älteren wie auch sehr aktuellen Screeninguntersuchungen bei über 95 % [13,23].…”

Ultrasound and magnetic resonance imaging in the prenatal diagnosis of open spina bifida

“…Several published papers analyzed the possibility of diagnosing spina bifida at the end of the first trimester of pregnancy by 2D and 3D US by evaluating other US markers such as: the anteroposterior diameter of the cisterna magna and the fourth ventricle (intracranial translucency), the brainstem diameter, the brainstem-occipital bone distance, the diameter of the roof of the third ventricle and the diameter of the aqueduct of Sylvius, in axial or mid-sagittal planes [33][34][35][36]. From all these measurements the antero-posterior decrease of the intracranial translucence (fourth ventricle) and the cisterna magna obliteration were proven to be the most common markers associated with spina bifida aperta in the first trimester of pregnancy [7,15,29,[32][33][34][35][36][37].…”

“…Several studies show a high sensitivity and specificity of 2D US in terms of evaluating bone anomalies, noting an increase in the detection of skeletal defects [8,[10][11][12][13][14]. The technical specifications of the US machine, such as a high-resolution and high frame rate, are essential to obtain quality images [6,15,16]. It is recommendable to visualize structures in at least two planes to lower the risk of artifacts.…”