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Updated: Apr 21, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Prenatal imaging of occipital encephaloceles
Gregor J Kasprian1, Michael J Paldino, Amy R Mehollin-Ray
1Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
Introduction:
This retrospective study aims to describe systematically the fetal cerebral MR morphology in cases with occipital meningoencephaloceles using standard and advanced fetal MRI techniques.
Material And Methods:
The 1.5-tesla MR examinations (T1- and T2-weighted imaging, echo planar imaging, EPI, diffusion-weighted imaging, DWI) of 14 fetuses with occipital/parietal meningoencephaloceles were retrospectively analyzed for the classification of anatomic characteristics. A diffusion tensor sequence was performed in 5 cases.
Results:
In 9/14 cases the occipital lobes were entirely or partially included in the encephalocele sac. Typical features of Chiari III malformation were seen in 6/14 cases. The displaced brain appeared grossly disorganized in 6/14. The brainstem displayed abnormal 'kinking'/rotation (3/14), a z-shape (1/14) and/or a molar tooth-like configuration of the midbrain (3/14). Tractography revealed the presence and position of sensorimotor tracts in 5/5 and the corpus callosum in 3/5. DWI was helpful in the identification of a displaced brain (in 8/9). EPI visualized the anatomy of draining cerebral veins in 7/9 cases. Clinical (9/14) and MRI (7/14) follow-up data are presented.
Discussion:
Encephaloceles show a wide range of morphological heterogeneity. Fetal MRI serves as an accurate tool in the visualization of brainstem, white matter pathway and cerebral venous involvement and facilitates the detection of specific underlying syndromes such as ciliopathies.
Insights
Fetal MRI reveals diverse brain abnormalities in occipital encephaloceles, including malformations like Chiari III and disorganized brain structures. Advanced MRI techniques accurately visualize brainstem, white matter, and venous involvement.
Area of Science:
- Neuroimaging
- Developmental Biology
- Radiology
Background:
- Occipital encephaloceles represent a significant congenital anomaly with variable presentations.
- Understanding the detailed fetal cerebral morphology is crucial for diagnosis and management.
Purpose of the Study:
- To systematically describe fetal cerebral magnetic resonance (MR) morphology in occipital encephaloceles.
- To evaluate the utility of standard and advanced fetal MRI techniques in characterizing these malformations.
Main Methods:
- Retrospective analysis of 1.5-tesla MR examinations in 14 fetuses with occipital/parietal encephaloceles.
- Inclusion of T1- and T2-weighted imaging, echo planar imaging (EPI), and diffusion-weighted imaging (DWI).
- Diffusion tensor imaging and tractography performed in a subset of cases.
Main Results:
- Occipital lobe involvement occurred in 9/14 cases, with Chiari III malformation in 6/14.
- Disorganized brain structures and abnormal brainstem configurations (kinking, z-shape, molar tooth sign) were observed.
- Tractography demonstrated sensorimotor tracts and corpus callosum; DWI and EPI aided in visualizing displaced brain and cerebral veins.
Conclusions:
- Fetal MRI effectively visualizes the morphological heterogeneity of encephaloceles.
- Advanced MRI techniques are valuable for assessing brainstem, white matter, and venous structures.
- Fetal MRI aids in detecting associated syndromes, such as ciliopathies.
