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Fine-tuning the Diagnosis of Fetal Scalp Cysts

The Value of High-frequency Sonography

Division of Obstetric and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York USA.

Address correspondence to Ilan E. Timor-Tritsch, MD, Division of Obstetric and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, New York University School of Medicine, 550 First Ave, NBV-9N26, New York, NY 10016 USA. E-mail: ilan.timor{at}med.nyu.edu

Objective. The purpose of this series is to emphasize the importance of an exhaustive and appropriately conducted sonographic examination in the correct diagnosis of fetal cystic scalp lesions and the place of magnetic resonance imaging (MRI) in the diagnostic sequence. Methods. Transabdominal and transvaginal 2- and 3-dimensional sonography with color and power Doppler imaging as well as 3-dimensional rendering techniques such as inversion and Doppler angiography were used. In 1 case, an MRI study was performed. Results. In 1 case, the MRI missed and the different sonographic techniques correctly made the diagnosis of a meningocele. In the second case, sonography was sufficient to establish the diagnosis of an epidermal cyst. Conclusions. These 2 cases show the value of going the distance with the newly available high-frequency sonography. Ultimately, the correct diagnoses were made with the tools offered by sonography without the need for any other imaging modality.

Key Words: fetal meningocele • magnetic resonance imaging • sonography

Abbreviations: MRI, magnetic resonance imaging • 3D, 3-dimensional • 2D, 2-dimensional