EURORAD ESR

Case 13628

Prenatal diagnosis and postnatal findings of cephalothoracopagus, janiceps, monosymmetros twins

Author(s)
Dr. Anjana Trivedi, MD Radiology1,
Dr. Anirudh Chawla, Resident, MD Radiology1,
Dr. Maulik Jethva, MD Radiology,
Dr. Hiral Hapani, MD Radiology

Civil Hospital,
P.D.U. Medical College;
Jamnagar Road
360001 Rajkot, India;
Email:anirudhchawla@gmail.com
 
Patient
female, 24 year(s)
 
 
  • Figure 1
    Fetal 3D ultrasound image

    3D ultrasound image of (A)- fetal face, showing low set ear, enlarged head and retrognathia. (B) 2 lower limbs arising from 2 pelvices with common upper abdomen.

     
    Area of Interest: Anatomy; Foetal imaging; Imaging Technique: Ultrasound; Procedure: Computer Applications-3D; Intrauterine diagnosis; Special Focus: Fetus; Obstetrics;
     
     
  • Figure 2
    Post natal coronal views of normal and abnormal face

    Postnatal coronal views show a relatively normal face with low set ears and retrognathia and a face consisting of only 2 partially fused ears. Fused head, thorax and upper abdomen with 8 limbs.

     
    Area of Interest: Anatomy; Foetal imaging; Forensic / Necropsy studies; Imaging Technique: Image manipulation / Reconstruction; Procedure: Intraoperative; Special Focus: Fetus; Pathology;
     
     
  • Figure 3
    Axial view of head

    Antenatal ultrasound and post mortem CT axial views of fetal head show 2 cerebral hemispheres forming an inverted V shape and partially fused thalami in an enlarged head.

     
    Area of Interest: Foetal imaging; Head and neck; Imaging Technique: CT; Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital; Fetus;
     
     
  • Figure 4
    Axial view of head

    Antenatal ultrasound and post mortem CT axial views of fetal head show 4 cerebellar hemispheres.

     
    Area of Interest: Foetal imaging; Head and neck; Neuroradiology brain; Imaging Technique: CT; Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital; Fetus; Pathology;
     
     
  • Figure 5
    Post mortem CT head, axial views

    A- Axial view of head shows 2 well-developed eyes. 2 pituitary glands are noted in sella tursica. B- Axial view, bone window shows 4 internal ear structures.

     
    Area of Interest: Ear / Nose / Throat; Head and neck; Neuroradiology brain; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital; Fetus; Pathology;
     
     
  • Figure 6
    Axial view of thorax

    Ultrasound and postmortem CT images of axial view of thorax show 2 spines facing each other and 2 hearts. The superior heart appears relatively normal while the inferior heart is hypoplastic.

     
    Area of Interest: Cardiovascular system; Foetal imaging; Thorax; Imaging Technique: CT; Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital; Fetus; Pathology;
     
     
  • Figure 7
    Serial coronal CT images
     

    Postmortem CT coronal image through right atrium. Formalin is acting as contrast agent. Hepatic veins converge into IVC and drain into right atrium. Another vessel is draining into right atrium from left side...

     
    Area of Interest: Cardiac; Cardiovascular system; Contrast agents; Imaging Technique: CT; Experimental; Procedure: Contrast agent-other; Diagnostic procedure; Special Focus: Congenital; Fetus;

    Postmortem CT coronal image through right atrium. Formalin is acting as contrast agent. The abnormal vessel draining into right atrium is traced cranialy on left side of the image.

     
    Area of Interest: Cardiac; Cardiovascular system; Imaging Technique: CT; Experimental; Procedure: Contrast agent-other; Diagnostic procedure; Special Focus: Fetus;

    The abnormal vessel draining into right atrium is traced cranialy as the internal jugular vein on left side of the image, thus, there is a persistant left superior vena cava.

     
    Area of Interest: Cardiac; Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Fetus;

    Postmortem CT coronal image through right atrium of the hypoplastic heart. Formalin is acting as contrast agent. Superior and inferior venacava are seen draining into right atrium.

     
    Area of Interest: Cardiac; Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 8
    Axial view of upper abdomen

    Ultrasound and postmortem CT axial images of upper abdomen showing 2 livers and 2 spines.

     
    Area of Interest: Abdomen; Foetal imaging; Liver; Imaging Technique: CT; Ultrasound; Procedure: Diagnostic procedure; Special Focus: Congenital; Fetus;
     
     
  • Figure 9
    Volume-rendered CT image

    Coronal and sagittal volume-rendered CT images with skeletal rendering showing fused skull vault, 2 spines with partial fusion of posterior elements of C3 to C5 vertebrae in both spines and 8 limbs.

     
    Area of Interest: Anatomy; Bones; Musculoskeletal system; Imaging Technique: CT; Image manipulation / Reconstruction; Procedure: Computer Applications-3D; Special Focus: Congenital; Fetus;
     
     
3D ultrasound image of (A)- fetal face, showing low set ear, enlarged head and retrognathia. (B) 2 lower limbs arising from 2 pelvices with common upper abdomen.
 
Postnatal coronal views show a relatively normal face with low set ears and retrognathia and a face consisting of only 2 partially fused ears. Fused head, thorax and upper abdomen with 8 limbs.
 
Antenatal ultrasound and post mortem CT axial views of fetal head show 2 cerebral hemispheres forming an inverted V shape and partially fused thalami in an enlarged head.
 
Antenatal ultrasound and post mortem CT axial views of fetal head show 4 cerebellar hemispheres.
 
A- Axial view of head shows 2 well-developed eyes. 2 pituitary glands are noted in sella tursica. B- Axial view, bone window shows 4 internal ear structures.
 
Ultrasound and postmortem CT images of axial view of thorax show 2 spines facing each other and 2 hearts. The superior heart appears relatively normal while the inferior heart is hypoplastic.
 
Postmortem CT coronal image through right atrium. Formalin is acting as contrast agent. Hepatic veins converge into IVC and drain into right atrium. Another vessel is draining into right atrium from left side inferiorly.
 
Postmortem CT coronal image through right atrium. Formalin is acting as contrast agent. The abnormal vessel draining into right atrium is traced cranialy on left side of the image.
 
The abnormal vessel draining into right atrium is traced cranialy as the internal jugular vein on left side of the image, thus, there is a persistant left superior vena cava.
 
Postmortem CT coronal image through right atrium of the hypoplastic heart. Formalin is acting as contrast agent. Superior and inferior venacava are seen draining into right atrium.
 
Ultrasound and postmortem CT axial images of upper abdomen showing 2 livers and 2 spines.
 
Coronal and sagittal volume-rendered CT images with skeletal rendering showing fused skull vault, 2 spines with partial fusion of posterior elements of C3 to C5 vertebrae in both spines and 8 limbs.
 
 
 
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