Sonography of fetal cerebrospinal anomalies

Abstract

Congenital anomalies of the central nervous system (CNS) are among the most frequent malformations. Current ultrasound equipment can give a precise diagnosis of many of these lesions from early gestation. High-resolution transvaginal probes play a major role both in allowing an early diagnosis and for better defining subtle details of both normal and abnormal cerebral anatomy. The diagnostic accuracy of prenatal ultrasound is, however, heavily dependent upon the expertise of the sonologist, the type of equipment employed, and the time dedicated to the scan. Fetal sonography is effective in identifying neural tube defects, although alpha-fetoprotein screening seems to give a greater sensitivity. The accuracy of ultrasound in the identification of CNS malformations other than neural tube defects remains unclear because of the ascertainment biases of the few large prospective studies that have been conducted to date.

The significance of fetal ventriculomegaly: etiology, short‐ and long‐term outcomes

“…VM can be secondary to disorders of neuronal proliferation (megalencephaly, microcephaly), neuronal migration (schizencephaly, lissencephaly), agenesis of the corpus callosum (ACC) or disorders of organogenesis, such as holoprosencephaly (Ashwal, 2001;Fong et al, 2004;Malinger et al, 2007;Pastorino et al, 2007). Finally, it can be the consequence of destructive processes of the cerebral matter, resulting from vascular insults or infections (Pilu and Hobbins, 2002;Zimmerman and Bilaniuk, 2005). Table 1 summarizes the etiologies of VM and the various associations.…”

CNS Abnormalities at 11-14 Weeks

“…Central nervous system (CNS) malformations are important, because they are the largest group of fetal abnormalities, more prevalent than trisomy 21 and similar to congenital heart diseases, accounting for more than 10 cases in 1000 births [3,4]. They also represent an important factor of morbidity and mortality among neonates and children, as some of these disorders become symptomatic only in early infancy.…”

Ultrasound Diagnosis of Congenital Brain Anomalies

“…Spinal US is used as an initial screening tool in the neonate with spinal and other congenital abnormalities. There is a high incidence of spinal abnormalities in babies who have other congenital syndromes (e.g., ano-rectal malformation, cloacal exstrophy, caudal regression and spinal segmentation abnormalities-the VATER/VACTEROL anomaly) (Pilu & Hobbins, 2002). Two types of scanning planes can be used to evaluate the integrity of the spine.…”