Evaluation of the lemon and banana signs in one hundred thirty fetuses with open spina bifida
Abstract
The incidence and diagnostic accuracy of the lemon and cerebellar ultrasonographic markers, as well as head size and ventriculomegaly, were evaluated in a study of 1561 patients at high risk for fetal neural tube defects. In the 130 fetuses with open spina bifida there was a relationship between gestational age and the presence of each of these markers. The lemon sign was present in 98% of fetuses at less than or equal to 24 weeks' gestation but in only 13% of those at greater than 24 weeks' gestation. Cerebellar abnormalities were present in 95% of fetuses irrespective of gestation; however, the cerebellar abnormality at less than or equal to 24 weeks' gestation was predominantly the banana sign (72%) whereas at gestations greater than 24 weeks it was cerebellar "absence" (81%). Both growth retardation and cerebral ventriculomegaly significantly worsened with gestation while the head circumference remained disproportionately small throughout gestation. On the basis of these data, a new approach is proposed for the investigation of patients at high risk for fetal open spina bifida.
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The most frequent severe spinal anomaly, open spina bifida, is usually associated with a characteristic cerebellar deformity and an obliterated cisterna magna.
“The most frequent severe spinal anomaly, open spina bifida, is usually associated with a characteristic cerebellar deformity and an obliterated cisterna magna 83 .”
From <scp>ISUOG</scp> Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan (2022) · cites this paper as [83]
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- Authors
- Van den Hof, M. C., Nicolaides, K. H., Campbell, J., & Campbell, S.
- Affiliations
- King's College London (GB)
- Corresponding author
- Nicolaides, Kypros H.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1990-02
- Volume
- 162
- Issue
- 2
- Pages
- 322-327
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2107615644
- Cited by
- 207
- References
- 16
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 5 · 2018: 3 · 2017: 8 · 2016: 3 · 2015: 8 · 2014: 9 · 2013: 12 · 2012: 10
- FWCI
- 7.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Spinal Dysraphism and Malformations
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Keywords
- open spina bifida, fetal neural tube defects, ventriculomegaly, fetal growth restriction, head circumference, gestational age, prenatal diagnosis, diagnostic accuracy
- MeSH terms
- Arnold-Chiari Malformation, Brain, Cerebellum, Female, Fetal Diseases, Humans, Pregnancy, Prenatal Diagnosis, Skull, Ultrasonography, Spina Bifida Occulta
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