EURORAD ESR

Case 15217

Dicephalic Parapagus - A rare variety of conjoined twins

Author(s)
Nanjaraj CP, Pradeep Kumar CN, Shashikumar MR, Rajendra Kumar NL, Pradeep HN, Ashwin Raghavendra A, Kavya Shree, Lal CG, Rashmi UT, Pankaj D, Dennis Titus, Sowmya J, Madhu P.

"BENAKA", # 1711, 8TH MAIN, HEBBAL, 2ND STAGE; 570 017 MYSORE, India; Email:drnanjaraj@gmail.com
 
Patient
female, 29 year(s)
 
 
  • Figure 1
    Antenatal Ultrasound
     

    Coronal image showing two vertebral columns in the dicephalic parapagus twins.

     
    Area of Interest: Foetal imaging; Imaging Technique: Ultrasound; Procedure: Education; Special Focus: Fetus;

    Axial image showing two fetal heads in close proximity to each other.

     
    Area of Interest: Foetal imaging; Imaging Technique: Ultrasound; Procedure: Education; Special Focus: Fetus;

    Axial image showing two vertebral columns in the dicephalic parapagus conjoined twins

     
    Area of Interest: Foetal imaging; Imaging Technique: Ultrasound; Procedure: Education; Special Focus: Fetus;
     
     
  • Figure 2
    Fetal MRI
     

    Coronal T2 Weighted image showing two separate heads and fused trunks of the dicephalic parapagus twins.

     
    Area of Interest: Foetal imaging; Imaging Technique: MR; Procedure: Education; Special Focus: Fetus;

    Axial T2 SPAIR image showing two fetal heads in close proximity to each other and an upper limb in posterior relation to the heads.

     
    Area of Interest: Foetal imaging; Imaging Technique: MR; Procedure: Education; Special Focus: Fetus;

    Axial T2 SPAIR image showing two fetal heads in close proximity to each other and two seperate sets of fingers arising from the upper limb.

     
    Area of Interest: Foetal imaging; Imaging Technique: MR; Procedure: Education; Special Focus: Fetus;
     
     
  • Figure 3
    Conventional Radiography

    Conventional radiograph after the demise of the expelled conceptus showing two vertebral columns, two lower limbs and three upper limbs.

     
    Area of Interest: Bones; Imaging Technique: Conventional radiography; Procedure: Education; Special Focus: Fetus;
     
     
  • Figure 4
    Computed Tomography
     

    Computed tomography image after the demise of the expelled conceptus shows two separate vertebral axes.

     
    Area of Interest: Bones; Imaging Technique: CT; Procedure: Education; Special Focus: Fetus;

    Axial image shows two separate lumbar vertebral columns and a single sacrum.

     
    Area of Interest: Bones; Imaging Technique: CT; Procedure: Education; Special Focus: Fetus;
     
     
  • Figure 5
    Gross specimen of the aborted dicephalic parapagus conjoined twins

    Two separate heads and two trunks fused medially with three upper limbs , two lower limbs and a single pelvis.

     
    Area of Interest: Education; Imaging Technique: PACS; Procedure: Biopsy; Special Focus: Fetus;
     
     
Coronal image showing two vertebral columns in the dicephalic parapagus twins.
 
Axial image showing two fetal heads in close proximity to each other.
 
Axial image showing two vertebral columns in the dicephalic parapagus conjoined twins
 
Coronal T2 Weighted image showing two separate heads and fused trunks of the dicephalic parapagus twins.
 
Axial T2 SPAIR image showing two fetal heads in close proximity to each other and an upper limb in posterior relation to the heads.
 
Axial T2 SPAIR image showing two fetal heads in close proximity to each other and two seperate sets of fingers arising from the upper limb.
 
Conventional radiograph after the demise of the expelled conceptus showing two vertebral columns, two lower limbs and three upper limbs.
 
Computed tomography image after the demise of the expelled conceptus shows two separate vertebral axes.
 
Axial image shows two separate lumbar vertebral columns and a single sacrum.
 
Two separate heads and two trunks fused medially with three upper limbs , two lower limbs and a single pelvis.
 
 
 
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