Twenty-Five Diagnoses on Midline Images of the Brain: From Fetus to Child to Adult

Abstract

Midsagittal images of the brain provide a wealth of anatomic information and may show abnormalities that are pathognomonic for particular diagnoses. Using an anatomy-based approach, the authors identify pertinent anatomic structures to serve as a checklist when evaluating these structures. Subregions evaluated include the corpus callosum, pituitary gland and sellar region, pineal gland and pineal region, brainstem, and cerebellum. The authors present 25 conditions with characteristic identifiable abnormalities at midsagittal imaging. Midsagittal views from multiple imaging modalities are shown, including computed tomography, ultrasonography, and magnetic resonance (MR) imaging. Standard MR imaging sequences are shown, as well as fetal MR and sagittal diffusion-weighted images. To demonstrate these conditions, fetal, neonatal, childhood, adolescent, and young adulthood images are reviewed. The differentiation of normal variants is guided by the understanding of anatomy and pathology. When a specific diagnosis is not possible, the authors present information to evaluate differential considerations and discuss when follow-up imaging may be indicated. The authors hope each case will clarify a pertinent differential diagnosis, appropriately guide patient management, and improve understanding of normal anatomy and identification of pathologic entities. It is in these hopes that the authors have presented a checklist of pertinent anatomy and pathologic entities that can build on existing search patterns. Improved confidence and accuracy in the evaluation of midsagittal images will benefit physicians and patients. RSNA, 2018.

The prevalence and the adding value of fetal MRI imaging in midline cerebral anomalies

“…Most midline brain anomalies obtained by the midsagittal plane of foetal MRI or US include commissural; corpus callosum; sellar, suprasellar, and pineal region; aqueductal stenosis; and posterior fossa, including the brainstem, cerebellum, and fourth ventricle, abnormalities [6].…”

The Influence of the Mandibular Chin Angle on the Occurrence of Mandibular Condylar Fracture: A Retrospective Study

“…The cerebral aqueduct of Sylvius connects the third ventricle to the fourth ventricle and can be viewed in the midsagittal image of the brain CT. This narrow channel ranges from 1 to 3 mm in diameter [ 25 ]. In the present study, the chin angle was measured in this particular midsagittal image with the cerebral aqueduct of Sylvius as the fixed reference plane to eliminate any observer bias.…”

“…is narrow channel ranges from 1 to 3 mm in diameter [25]. In the present study, the chin angle was measured in this particular midsagittal image with the cerebral aqueduct of Sylvius as the fixed reference plane to eliminate any observer bias.…”

Fetal brain imaging: A comparison between fetal ultrasonography and intra uterine magnetic resonance imaging (a systematic review and meta‐analysis)

“…In addition, MRI allows the fetal brain to be evaluated, especially when the fetus is at greater risk for neurodevelopmental disorders or when abnormalities are detected on prenatal US 1 . Most midline abnormalities of the brain in the mid‐sagittal plane of the fetal MRI or US are as follows: Corpus Callosum; aqueductal stenosis; sellar; commissural; suprasellar and pineal; posterior fossa including the brainstem, cerebellum, and fourth ventricle 6 . For the past two decades, the use of fetal brain MRI has been accepted as a complementary method.…”

“…1 Most midline abnormalities of the brain in the midsagittal plane of the fetal MRI or US are as follows: Corpus Callosum; aqueductal stenosis; sellar; commissural; suprasellar and pineal; posterior fossa including the brainstem, cerebellum, and fourth ventricle. 6 For the past two decades, the use of fetal brain MRI has been accepted as a complementary method. However, the indications and further value of this method, especially in combination with fetal US, with sometimes contradictory results, have not been fully established.…”