The Imaging Spectrum of Conjoined Twins

Abstract

Conjoined twins are a rare complication of monochorionic twinning. Although most conjoined twins are stillborn or die in the newborn period, surgical advances are such that many parents will continue a pregnancy in the hopes that live born infants can be separated. Well-described types of conjoined twins account for most cases, with some rarer forms occasionally seen. Each type is associated with specific degrees of organ sharing, structural abnormalities, complications, and challenges with regard to potential separation. Thorough multidisciplinary prenatal assessment of conjoined twins is essential to appropriately counsel parents, to manage the pregnancy, and to create an appropriate delivery plan. This pictorial essay presents the imaging findings of the more common types of conjoined twins. Selected clinical and autopsy images are used to illustrate shared anatomy. The nomenclature for description of conjoined twins is reviewed, the imaging findings of each type are illustrated, and the challenges to separation are discussed.

Detection Cephalothoracopagus Case in the First Trimester

“…7 Sefalotorakopagus görülme oranı yapışık ikizler arasında %11'dir. 8 Nukal saydamlık artışı birinci trimesterde yapışık ikizlerle ilgili olarak saptanan en sık anormalliktir. Ultrasonografik incelemede saptanan diğer anomaliler; lenfanjiektazi, hidrops fetalis ve ödem; kistik higroma, abdominal duvar defektleri (omfalosel, gastroşizis veya cantrell pentalojisi), nöral tüp defektleri, konjenital kalp defektleri, talipes ve renal agenezidir.…”

Unusual Conjoint Twins

“…65% of cases are stillborn while of those that are born alive, 35% die within the first 24 hours [4]. Only 25% survive to an age where surgical separation can be considered [5].…”

Prenatal diagnosis of conjoined twins: Four cases in a prenatal center

“…The combination of different types can occur, but the most frequently seen types include thoracopagus (20-40%), omphalopagus (18-33%), and parapagus (28%). Rachipagus is the rarest type of conjoined twins with an incidence of approximately 2% (8,9). The sonographic diagnosis of conjoined twins was first reported by Wilson et al (6).…”