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Integrating 2D and 3D Multiplanar Sonography in the Prenatal Diagnosis of Arnold-Chiari Type 2 Malformation

Department of Obstetrics & Gynecology, Guastalla Civil Hospital, Guastalla Reggio Emilia, Italy, Tonni.Gabriele{at}ausl.re.it

Alessandro Ventura, MD

Department of Obstetrics & Gynecology, Guastalla Civil Hospital, Guastalla Reggio Emilia, Italy

Arnold-Chiari type 2 malformation is a congenital deformity characterized by displacement of cerebellar tonsils, parts of the corpus callosum, and the medulla oblongata through the foramen magnum into the spinal canal. Sonographic diagnostic criteria are based on the "lemon sign" of the cephalic pole, enlargement of the lateral ventricle, and abnormalities of the posterior fossa consisting of an anomalous profile of the cerebellar hemispheres ("banana sign") associated with a reduced or absent cisterna magna. Identification of a large, open neural tube defect is the other hallmark of the prenatal sonographic diagnosis. Multiplanar 3D enhances the definition and the exact extension of the spine defect and has the potential of calculating the amount of cerebellar hemispheres undergoing herniation through the foramen of Magendie and Lutchka, which is one of the main factors in predicting or modifying the postnatal neurosurgery strategy and the subsequent postnatal neurodevelopmental outcome.

Key Words: prenatal diagnosis • 3D multiplanar sonography • hydrocephalus • open spina bifida • Arnold-Chiari malformation

References

• Lindenberg R, Walker BA: Arnold-Chiari malformation in sibs. Birth Defects Orig Art Ser VII(1):234.
• Babcook CJ, Goldstein RB, Barth RA, Damato NM, Callen PW, Filly RA: Prevalence of ventriculomegaly and correlation with gestational age and severity of posterior fossa deformity. Radiology 1994;190:703-707.[Abstract/Free Full Text]
• Nicolaides KH, Campbell S, Gabbe SG, Guidetti R: Ultrasound screening for spina bifida: cranial and cerebellar signs. Lancet 1986;12:72-74.
• Van den Hof MC, Nicolaides KH, Campbell J, Cvampbell S: Evaluation of the lemon and banana sign in spina bifida. Am J Obstet Gynecol 1990;162:322-327.[Medline] [Order article via Infotrieve]
• Bernard JP, Suarez B, Rambaud C, Muller F, Ville Y: Prenatal diagnosis of neural tube defect before birth: ultrasonographic semiology. Ultrasoun Obstet Gynecol 1997;10:406-409.[CrossRef]
• Mueller GM, Weiner CP, Yankowitz J: Three-dimensional ultrasound in the evaluation of fetal head and spine anomalies. Obstet Gynecol 1996;88:372-378.[CrossRef][Medline] [Order article via Infotrieve]
• Blaas HG, Eik-Nes SH, Isaken CV: The detection of spina bifida before 10 gestational weeks using two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2000;16:25-29.[Medline] [Order article via Infotrieve]
• Hata T, Yanagihara T, Matsumoto M, et al.: Three-dimensional sonographic features of fetal central nervous system anomaly. Acta Obstet Gynecol Scand 2000;79:635-639.[Medline] [Order article via Infotrieve]
• Bonilla-Musoles F, Machado LE, Osborne NG, et al.: Two- and three-dimensional ultrasound in malformations of the medullary canal: report of four cases. Prenat Diagn 2001;21:622-626.[Medline] [Order article via Infotrieve]
• Lee W, Chaiworapongsa T, Romero R, et al.: A diagnostic approach for the evaluation of spina bifida by three dimensional ultrasonography. J Ultrasound Med 2002;21: 619-626.[Abstract/Free Full Text]
• Sutton LN, Adzick NS, Bilaniuk LT, Johnson MP, Crombleholme TM, Flake AW: Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele. JAMA 1999;282:1826-1831.[Abstract/Free Full Text]

Journal of Diagnostic Medical Sonography, Vol. 22, No. 1, 24-28 (2006)
DOI: 10.1177/8756479305283991


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tonni, G. Articles by Ventura, A. Search for Related Content Social Bookmarking                         What's this?