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Practical approach to prenatal posterior fossa abnormalities using MRI

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Abstract

This review focuses on the optimum use of fetal MRI as an additional imaging tool to sonographic data in posterior fossa (PF) abnormalities in the second and third trimesters of gestation. We have chosen three particular situations to demonstrate the value of MRI as a complementary investigation to US: (1) the pattern of increased fluid-filled space of the PF, (2) decreased cerebellar sonographic biometry and (3) the diagnosis of focal echogenic lesions of the cerebellum. For increased fluid-filled space of the PF and decreased cerebellar sonographic biometry, a practical approach is proposed, largely based on prenatal imaging, especially MRI.

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References

  1. Guibaud L (2002) Anomalies de la fosse cérébrale postérieure. In: Garel C, Delezoide AL, Guibaud L (eds) Imagerie du cerveau fœ tal pathologique. Sauramps Medical, Montepellier, pp 99–118

  2. Altman NR, Naidich TP, Braffman BH (1992) Posterior fossa malformations. AJNR 13:691–724

    CAS  Google Scholar 

  3. Kollias SS, Ball WS Jr, Prenger EC (1993) Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis. Radiographics 13:1211–1231

    CAS  PubMed  Google Scholar 

  4. Poutamo J, Vanninen R, Partanen K, et al (1999) Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 13:327–34

    Article  CAS  PubMed  Google Scholar 

  5. Garel C, Chantrel E, Sebag G, et al (2000) Le développement du cerveau fœ tal. Atlas IRM et biométrie. Sauramps Médical, Montpellier

  6. Adamsbaum C, Merzoug V, André C, et al (2002) Prenatal diagnosis of isolated posterior fossa anomalies: attempt at a simplified approach. J Radiol 83:321–328

    CAS  PubMed  Google Scholar 

  7. Klein O, Pierre-Kahn A, Boddaert N, et al (2003) Dandy-Walker malformation: prenatal diagnosis and prognosis. Childs Nerv Syst 19:484–489

    Article  CAS  PubMed  Google Scholar 

  8. Estroff JA, Scott MR, Benacerraf BR (1992) Dandy-Walker variant: prenatal sonographic features and clinical outcome. Radiology 185:55–58

    Google Scholar 

  9. Ecker JL, Shipp TD, Bromley B, et al (2000) The sonographic diagnosis of Dandy-Walker and Dandy-Walker variant: associated findings and outcomes. Prenat Diagn 20:328–332

    Article  CAS  PubMed  Google Scholar 

  10. Barkovich AJ, Kjos BO, Norman D, et al (1989) Revised classification of posterior fossa cysts and cyst-like malformations based on the results of multiplanar MR imaging. AJR 153:1289–1300

    CAS  PubMed  Google Scholar 

  11. Nyberg DA, Mahony BS, Hegge FN, et al (1991) Enlarged cisterna magna and the Dandy-Walker malformation: factors associated with chromosome abnormalities. Obstet Gynecol 77:436–442

    CAS  PubMed  Google Scholar 

  12. Kolble N, Wisser J, Kurmanavicius J, et al (2000) Dandy-Walker malformation: prenatal diagnosis and outcome. Prenat Diagn 20:318–327

    Article  CAS  PubMed  Google Scholar 

  13. Ramaekers VT, Heimann G, Reul J, et al (1997) Genetic disorders and cerebellar structural abnormalities in childhood. Brain 120:1739–1751

    Article  PubMed  Google Scholar 

  14. Bromley B, Nadel AS, Pauker S, et al (1994) Closure of the cerebellar vermis: evaluation with second trimester US. Radiology 193:761–763

    CAS  PubMed  Google Scholar 

  15. Laing FC, Frates MC, Brown DL, et al (1994) Sonography of the fetal posterior fossa: false appearance of mega-cisterna magna and Dandy-Walker variant. Radiology 192:247–251

    Google Scholar 

  16. Harwood-Nash DC, Fitz CR (1976) Neuroradiology in infants and children, vol 3. Mosby, St. Louis, pp 1014–1019

  17. Raybaud C (1982) Cystic malformations of the posterior fossa. Abnormalities associated with the development of the roof of the fourth ventricle and adjacent meningeal structures. J Neuroradiol 9:103–133

    CAS  PubMed  Google Scholar 

  18. Tortori-Donati P, Fondelli MP, Rossi A, et al (1996) Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake’s pouch: two separate entities. Childs Nerv Syst 12:303–308

    CAS  PubMed  Google Scholar 

  19. Goldstein I, Reece EA, Pilu G, et al (1987) Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. Am J Obstet Gynecol 156:1065–1069

    CAS  PubMed  Google Scholar 

  20. Hill LM, Guzick D, Fries J, et al (1990) The transverse cerebellar diameter in estimating gestational age in the large for gestational age fetus. Obstet Gynecol 75:981–985

    CAS  PubMed  Google Scholar 

  21. Barth PG (1993) Pontocerebellar hypoplasias. An overview of a group of inherited neurodegenerative disorders with fetal onset. Brain Dev 15:411–422

    Article  CAS  PubMed  Google Scholar 

  22. Barth PG (2000) Pontocerebellar hypoplasia—how many types? Eur J Paediatr Neurol 4:161–162

    Article  CAS  PubMed  Google Scholar 

  23. Mathews KD, Afifi AK, Hanson JW (1989) Autosomal recessive cerebellar hypoplasia. J Child Neurol 4:189–194

    CAS  PubMed  Google Scholar 

  24. Vinkesteijn AS, Jansen CL, Los FJ, et al (2001) Fetal transcerebellar diameter and chromosomal abnormalities. Ultrasound Obstet Gynecol 17:502–505

    Article  CAS  PubMed  Google Scholar 

  25. Goasdoue P, Rodriguez D, Moutard ML, et al (2001) Pontoneocerebellar hypoplasia: definition of MR features. Pediatr Radiol 31:613–618

    Article  CAS  PubMed  Google Scholar 

  26. Graber D, Antignac C, Deschenes G, et al (2001) Cerebellar vermis hypoplasia with extracerebral involvement (retina, kidney, liver): difficult to classify syndromes. Arch Pediatr 8:186–190

    Article  CAS  PubMed  Google Scholar 

  27. Boltshauser E, Steinlin M, Martin E, et al (1996) Unilateral cerebellar aplasia. Neuropediatrics 27:50–53

    CAS  PubMed  Google Scholar 

  28. Kendall B, Kingsley D, Lambert SR, et al (1990) Joubert syndrome: a clinico-radiological study. Neuroradiology 31:502–506

    CAS  PubMed  Google Scholar 

  29. Obersteiner H (1914) Ein Kleinhirn ohne Wurm. Arb Neurol Inst (Wien) 124–136

  30. Utsunomiya H, Takano K, Ogasawara T, et al (1998) Rhombencephalosynapsis: cerebellar embryogenesis. AJNR 19:547–549

    CAS  Google Scholar 

  31. Aydingoz U, Cila A, Aktan G (1997) Rhombencephalosynapsis associated with hand anomalies. Br J Radiol 70:764–766

    CAS  PubMed  Google Scholar 

  32. Simmons G, Damiano TR, Truwit CL (1993) MRI and clinical findings in rhombencephalosynapsis. J Comput Assist Tomogr 17:211–214

    CAS  PubMed  Google Scholar 

  33. Truwit CL, Barkovich AJ, Shanahan R, et al (1991) MR imaging of rhombencephalosynapsis: report of three cases and review of the literature. AJNR 12:957–966

    CAS  Google Scholar 

  34. Litherland J, Ludlam A, Thomas N (1993) Antenatal ultrasound diagnosis of cerebellar vermian agenesis in a case of rhombencephalosynapsis. J Clin Ultrasound 21:636–638

    CAS  PubMed  Google Scholar 

  35. Sharony R, Kidron D, Aviram R, et al (1999) Prenatal diagnosis of fetal cerebellar lesions: a case report and review of the literature. Prenat Diagn 19:1077–1080

    Article  CAS  PubMed  Google Scholar 

  36. Guibaud L, Garel C, Annie B, et al (2003) Prenatal diagnosis of capillary telangiectasia of the cerebellum-ultrasound and MRI features. Prenat Diagn 23:791–796

    Article  PubMed  Google Scholar 

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Acknowledgements

Special thanks for Drs. V. Desportes and C. Rousselle (Centre Hospitalier Lyon-Sud, Department of Neuropediatrics) and Dr. P. Droulle (Maternité Pinard, Nancy) for their pertinent advice in the completion of this article.

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Correspondence to Laurent Guibaud.

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Guibaud, L. Practical approach to prenatal posterior fossa abnormalities using MRI. Pediatr Radiol 34, 700–711 (2004). https://doi.org/10.1007/s00247-004-1248-y

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