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Research ArticlePediatric Neuroimaging

Correlation of Prenatal and Postnatal MRI Findings in Schizencephaly

S.A. Nabavizadeh, D. Zarnow, L.T. Bilaniuk, E.S. Schwartz, R.A. Zimmerman and A. Vossough
American Journal of Neuroradiology July 2014, 35 (7) 1418-1424; DOI: https://doi.org/10.3174/ajnr.A3872
S.A. Nabavizadeh
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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D. Zarnow
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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L.T. Bilaniuk
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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E.S. Schwartz
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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R.A. Zimmerman
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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A. Vossough
aFrom the Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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    Fig 1.

    Measurement of the outer, middle, and inner widths of the schizencephalic cleft.

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    Fig 2.

    Prenatal imaging at 22 weeks' gestational age demonstrates bilateral wide-open clefts on axial (A) and coronal HASTE (B and C) imaging. Postnatal imaging at 15 months of age demonstrates interval closure of both defects, with apposed lips that contain intervening vessels. Note the complete absence of the septum pellucidum. Axial T2 (D), axial FLAIR (D and E), and coronal T2 (F) images are shown.

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    Fig 3.

    Prenatal coronal HASTE imaging at 26 weeks' gestational age demonstrating a right temporal open cleft communicating with the temporal horn (arrow), with a faint membrane covering (A). Postnatal coronal T2 imaging at 2 months of age demonstrates interval closure of defect lips, which are now apposed to each other and closed (B).

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    Fig 4.

    Prenatal imaging at 29 weeks' gestational age. Axial HASTE image (A) reveals an open cleft with a membrane along the roof of the cleft (arrow), which remained open in postnatal imaging 1 month after birth (B).

Tables

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    Table 1:

    Imaging characteristics of patients with schizencephaly

    SubjectCleftsPrenatal: Visualization of Cortex Lining the 2 Margins of the CleftPostnatal: Visualization of Cortex Lining the 2 Margins of the CleftPrenatal: Membrane along the CleftPostnatal: Membrane along the CleftPrenatal: Evidence of HemorrhagePostnatal: Evidence of Hemorrhage
    1RPartial-partialComplete-completePresentAbsentBilateral ventricular hemosiderin stainingAbsent
    LComplete-partialComplete-completeAbsentAbsentRight choroid plexus hemorrhage
    2LComplete-partialComplete-completeAbsentAbsentAbsentAbsent
    LComplete-completeComplete-completeAbsentAbsent
    3RComplete-partialComplete-completePresentAbsentAbsentAbsent
    LComplete-completeComplete-completePresentAbsent
    4RComplete-partialComplete-completeAbsentAbsentAbsentAbsent
    LComplete-partialComplete-completeAbsentAbsent
    5RComplete-completeComplete-completePresentAbsentLeft lateral ventricle and choroid plexus gross hemorrhageBilateral ventricular staining, left choroid plexus staining
    LComplete-partialComplete-completePresentAbsent
    6LComplete-completeComplete-completeAbsentAbsentHemosiderin staining in the cleftBilateral ventricular and cleft staining
    7RComplete-partialComplete-completeAbsentAbsentAbsentLeft choroid plexus hemorrhage
    LComplete-partialComplete-completeAbsentAbsent
    8LComplete-partialComplete-completePresentPartialBilateral ventricular, choroid plexus, and cleft hemosiderin stainingBilateral ventricular, choroid plexus, and cleft hemosiderin staining
    9RComplete-partialComplete-completePresentAbsentBilateral ventricular hemosiderin stainingBilateral ventricular hemosiderin staining
    LComplete-partialComplete-completePresentAbsent
    10RComplete-completeComplete-completePresentAbsentBilateral ventricular hemosiderin stainingBilateral ventricular hemosiderin staining
    RComplete-completeComplete-completePresentPresent
    • Note:—R indicates right; L, left.

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    Table 2:

    Comparison of the dimensions of the clefts and ipsilateral ventricle between different types of open cleftsa

    MeasurementNormalized Prenatal Diameters (Open Clefts That Closed)Normalized Prenatal Diameters (Open Clefts That Remained Open)P Value
    Ipsilateral ventricleMean = 0.16 ± 0.045Mean = 0.14 ± 0.039.24
    Cleft width (outer)Mean = 0.17 ± 0.14Mean = 0.27 ± 0.13.11
    Cleft width (inner)Mean = 0.14 ± 0.88Mean = 0.20 ± 0.12.14
    Cleft width (mid)Mean = 0.12 ± 0.08Mean = 0.23 ± 0.13.06
    • ↵a Measurements are all normalized to the mean of the maximum anteroposterior and transverse inner diameters of the skull.

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American Journal of Neuroradiology: 35 (7)
American Journal of Neuroradiology
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Cite this article
S.A. Nabavizadeh, D. Zarnow, L.T. Bilaniuk, E.S. Schwartz, R.A. Zimmerman, A. Vossough
Correlation of Prenatal and Postnatal MRI Findings in Schizencephaly
American Journal of Neuroradiology Jul 2014, 35 (7) 1418-1424; DOI: 10.3174/ajnr.A3872

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Correlation of Prenatal and Postnatal MRI Findings in Schizencephaly
S.A. Nabavizadeh, D. Zarnow, L.T. Bilaniuk, E.S. Schwartz, R.A. Zimmerman, A. Vossough
American Journal of Neuroradiology Jul 2014, 35 (7) 1418-1424; DOI: 10.3174/ajnr.A3872
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