2024年8月21日 · Myelomeningocele, also known as spina bifida cystica, is a complex congenital spinal anomaly that results in spinal cord malformation (myelodysplasia). It is one of the most common congenital CNS anomalies and is thought to occur in approximately 1:500 of live births 5. There may be a slight female predilection.

When elements of spinal cord and/or nerves are present, it is termed a meningomyelocele (or myelomeningocele). This is the most common lesion, accounting for more than 90% of cases. Myeloschisis occurs when the open neural tube is not covered and is open to the exterior.

Myelomeningocele is a major congenital anomaly caused by a defective closure of the neural tube between the 18–25 th days of gestation, resulting in the protrusion of the cord and the meninges through the defective bony encasement of the spinal column [1].

In cases of meningocele and myelomeningocele, the sac is best seen in the posterior longitudinal and posterior transaxial planes. It is important to get the spine away from the uterine wall. The spinal level can be accurately estimated by counting the vertebral segments: In 95% of cases S1 is at the top of the iliac wing.

Prenatal diagnosis of spina bifida is possible at second trimester of gestation through α-fetoprotein and acetylcholinesterase biochemistry assays and ultrasound. In particular, the discovery of characteristic intracranial signs on ultrasound leads to a very high diagnosis rate.

While ultrasound is very good at delineating the major features of the malformation, MRI has been shown to provide better characterization of brain anomalies and superimposed, acquired insults.

Standard 2-dimensional ultrasound at 9 weeks revealed a grossly abnormal posterior brain and 2 adjacent sonolucent structures: 2 yolk sacs versus a yolk sac and cyst. Imaging by 3-dimensional ultrasound distinguished these structures, revealing a caudal cyst with continuity of fetal tissue consistent with a meningomyelocele.

iews demonstrate that, to date, meningomyeloceles have not been identified on ultrasound within the first trimester. MedLine searches reveal that the most common time for identification of neural tu

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Diagnosis of meningomyelocele typically involves prenatal ultrasound imaging to visualize structural abnormalities. Maternal blood tests can indicate elevated alpha-fetoprotein (AFP) …