Prevalence of aneuploidy and additional anatomic abnormalities in fetuses and neonates with cleft lip with or without cleft palate: a population-based study in Utah.

Objective: To determine the prevalence of aneuploidy and additional major anatomic abnormalities in fetuses and neonates with cleft lip with or without cleft palate.

Methods: All cases of cleft lip with or without cleft palate (cleft lip/cleft palate) occurring in Utah from 1995 through 1999 were reviewed by using the Utah Birth Defect Network population-based surveillance system. All pregnancy outcomes are included (stillborn, live born, and termination) in this analysis.

MR, CT, and plain film imaging of the developing skull base in fetal specimens.

Background And Purpose: The developing fetal skull base has previously been studied via dissection and low-resolution CT. Most of the central skull base develops from endochondral ossification through an intermediary chondrocranium. We traced the development of the normal fetal skull base by using plain radiography, MR imaging, and CT.

Prevalence of aneuploidy and additional anatomic abnormalities in fetuses with open spina bifida: population based study in Utah.

Data were used to determine the population prevalence of aneuploidy and additional anatomic abnormalities in fetuses with open spina bifida. The ability of sonography to predict aneuploidy and identify additional anatomic abnormalities in euploid fetuses was assessed. All cases of spina bifida occurring in the state of Utah from 1995 through 1997 were reviewed using Utah Birth Defect Network data, including stillborn, liveborn, and terminated cases.

Effect of maternal hydration on mild fetal pyelectasis.

The aim of our study was to determine whether maternal hydration status prior to prenatal sonography affects fetal renal pelvic diameter. The renal pelvic diameters of fetuses from two different institutions were compared prospectively. At one institution 74 women were asked to drink 32 to 48 ounces of water prior to undergoing sonography (hydration group), whereas at the second institution, no specific hydration regimen was requested of 176 subjects.

Axial ultrasonographic imaging of the fetal maxilla for accurate characterization of facial clefts.

The purpose of this study was to determine whether scanning of the fetal midface in the axial plane allows accurate characterization of facial clefts. During fetal anatomic survey, facial clefts were identified in six fetuses. The midface anatomy was evaluated with ultrasonography in the coronal and axial planes, and the clefts were characterized prospectively as unilateral or bilateral and as involving the lip alone or both the lip and the palate.

A magnetic resonance template for normal cerebellar development in the human fetus.

Objective: Although ultrasound is the primary imaging modality for prenatal anatomic evaluation, some central nervous system malformations may be better defined with high-resolution magnetic resonance imaging (MRI). MRI allows us to visualize the features of brain development that were previously only seen histologically by embryologists and anatomists. Although there are several reports of the postnatal development of the cerebellum as revealed on magnetic resonance (MR) images, systematic MR studies of cerebellar development during the fetal period are lacking.

Spinal level of fetal myelomeningocele: does it influence ventricular size?

Objective: Our objective was to determine whether the level of the spinal defect influences ventricular size in fetuses with myelomeningoceles.

Materials And Methods: Sonograms of 51 fetuses with open spina bifida were reviewed to determine the gestational age, ventricular atrial diameter, severity of posterior fossa deformity, and the level of the spinal defect. Four categories for spinal defect level were used: sacral, low lumbar, high lumbar, and thoracic.

Ruptured malignant ovarian tumor mimicking ruptured ectopic pregnancy.

Ovarian carcinoma is uncommon in premenopausal women and few cases appear during pregnancy. Acute symptoms, such as pain secondary to rupture or torsion, are unusual. The majority of women with epithelial ovarian carcinoma remain asymptomatic for long periods of time.

Evaluation of fetal midface anatomy related to facial clefts: use of US.

Purpose: To identify the sonographic appearance of normal fetal midface anatomy of in vitro fetal specimens and to correlate the appearance with that of in utero fetuses to determine which aspects of this anatomy can be evaluated clinically.

Materials And Methods: The midface structures of 12 normal fetal specimens were examined in the axial, sagittal, and coronal planes with ultrasound. The results were correlated with those of other modalities.

Imaging findings of the developing temporal bone in fetal specimens.

Purpose: To trace the development of the normal fetal temporal bone by means of plain radiography, MR, and CT.

Methods: Eighteen formalin-fixed fetal specimens, 13.5 to 24.

A magnetic resonance template for normal neuronal migration in the fetus.

Objective: Although the features of neuronal migration have been known since the turn of the century, the serial features of neuronal migration as seen with magnetic resonance imaging (MRI) have not been described. Our objective was to provide a template of the normal appearance and the temporal pattern of neuronal migration in the human fetal brain early in the second trimester as seen with MR imaging and to correlate our findings with histological sections and atlases.

Methods: Twenty-eight normal fetal specimens, which ranged from 9 to 24 weeks of gestational age, were imaged with a 1.

Sonographic anatomy of the developing cerebellum: normal embryology can resemble pathology.

Objective: The aims of this study were to evaluate sonographically observable fetal cerebellar development by use of MR image and anatomic correlations to determine what aspects of this development can be visualized by sonography and to define the normal sonographic appearance of cerebellar development to assist in the differentiation of normal development from pathologic development during prenatal sonography.

Materials And Methods: The posterior fossae of 19 normal, whole, fixed fetal specimens of 11-21 weeks' gestational age were imaged by sonography and MR imaging. Images were correlated with anatomic atlases and anatomic sections.

Ultrasound evaluation of prenatal and neonatal spina bifida.

Interest in studying the role of sonography in the evaluation of newborns and infants with spinal dysraphism waned with the advent of MR imaging. Sonographic evaluation of the neonatal spine, however, can be performed portably, is relatively inexpensive when compared with MR imaging, and does not require sedation. Its recognized utility in evaluating the neonatal spine in both open and occult spinal dysraphisms makes sonography an ideal diagnostic modality for this patient population.

Prenatally detected fetal myelomeningocele: is karyotype analysis warranted?

Purpose: To determine the prevalence of karyotype abnormalities in fetuses with prenatally detected spina bifida and evaluate the ability of prenatal sonography to enable prediction of chromosomal abnormalities.

Materials And Methods: Sonograms from 63 fetuses with prenatally detected spina bifida were reviewed, and associated sonographic abnormalities were recorded. Sonographic findings were correlated with autopsy or clinical findings when possible.

Gastroschisis: can sonography of the fetal bowel accurately predict postnatal outcome?

To determine whether prenatal sonographic features of the small bowel can accurately predict postnatal outcome in fetuses with gastroschisis, the sonograms of 24 fetuses with prenatally detected gastroschisis were retrospectively reviewed for fetal bowel features including small bowel dilatation and bowel wall thickening. To identify a relationship between the sonographic features and neonatal outcome, each feature was analyzed against eight adverse clinical outcome measures including bowel obstruction or atresia, necrosis, and need for bowel resection, using chi-square analysis and Kendall's taub correlation. When a relationship was identified, the sensitivity and specificity of the sonographic feature for predicting adverse outcome were determined.

Sonography of ovarian masses: poor sensitivity of resistive index for identifying malignant lesions.

Objective: Current research suggests that the resistive index of adnexal masses is a sensitive measure for distinguishing between benign and malignant ovarian masses. We devised a study to determine how morphologic findings on sonograms compare with the resistive index of benign and malignant lesions.

Subjects And Methods: Pelvic sonograms were obtained in 34 women with 36 adnexal masses that were likely neoplastic or non-self-limiting (such as an endometrioma).

Prevalence of ventriculomegaly in association with myelomeningocele: correlation with gestational age and severity of posterior fossa deformity.

Purpose: To investigate the relationship of ventriculomegaly (VM) with gestational age (GA) and the severity of the associated Chiari II malformation.

Materials And Methods: The sonograms of 51 fetuses with myelomeningoceles were retrospectively reviewed. VM was judged to be present when the transverse ventricular atrial diameter was greater than 10 mm.

Effect of clinical history on the interpretation of chest radiographs in childhood bronchiolitis.

Rationale And Objectives: This study assesses the effect of a clinical history of "bronchiolitis" versus "well child" on the interpretation of pediatric chest radiographs.

Methods: Radiologists reviewed radiographs previously identified as "definite bronchiolitis," "equivocal bronchiolitis," "definite normal," and "equivocal normal." They were asked to identify features of bronchiolitis and give a confidence level for their diagnosis.

The correlation of feature identification and category judgments in diagnostic radiology.

Expert and novice radiologists were given films accompanied by clinical histories that supported a diagnosis either of bronchiolitis or of normal. To provide a plausible task context, some films were radiologically unambiguous and were accompanied by histories consistent with them. For a set of radiologically difficult films from confirmed normal or bronchiolitis patients, fictitious normal or abnormal histories were counterbalanced with the films.

Observer variation in detecting the radiologic features associated with bronchiolitis.

Chest radiographs are commonly obtained to assess children for bronchiolitis, both to corroborate the diagnosis and to exclude other diagnostic possibilities. Their utility in this setting has not previously been examined. Using a blinded, randomized study design, we examined the interobserver and intraobserver variation in the detection of the radiologic features of bronchiolitis from the chest radiograph using "weighted kappa" statistics.