Findings: 1.5 Tesla MRI of fetus at 34 weeks (focus on brain) with
T2 weighted half-Fourier acquisition single-shot turbo spin echo,
and without intravenous contrast (Figure 1-6):
1. BPD = 73mm; FOD = 86mm
Cephalic index = (73/86)*100 = 84.9, within normal limit.
HC = (73+86)x1.57 = 249.6mm.
Estimated gestational age: 24.6-28.2 (26.9) weeks.
Considering true gestational age of 34 weeks, small head size
should be considered.
Transcerebellar diameter (TCD): 32.8mm.
2. Smooth agyric brain with the brain morphology like 23-24
gestational weeks, suggesting abnormal cortical sulcation such as
lissencephaly.
Presence of shallow sylvian fissures (figure-of-eight appearance)
and sommth gray-white matter interface.
3. Enlarged subarachnoid spaces with ventricular enlargement,
in favor of ventriculomegaly due to delayed cortical growth
rather than hydrocephalus.
4. Large amount of amniotic fluid in the amniotic sac (figure 6),
in favor of polyhydramnios.
5. Elevating of chorioamnionic membrane from uterine wall with much
long T2 fluid accumulation between the chorioamnionic membrane
and the uterus, suggesting subchorionic effusion/hematoma.
Impression:
1. Small head size with abnormal cortical sulcation,
lissencephaly.
2. Polyhydramnios with subchorionic effusion/hematoma.
Photograph after birth (figure 7):
1. Microcephaly (head circumference= 28cm, < 3%)
1. A short nose with a depressed nasal root.
2. Anteversion of nostrils.
3. Vertical furrowing of the forehead when crying
(arrow in figure 7).