Cited by 207Spinal Dysraphism and MalformationsFetal and Pediatric Neurological DisordersPrenatal Screening and Diagnostics

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Evaluation of the lemon and banana signs in one hundred thirty fetuses with open spina bifida

Van den Hof, Michiel C., Nicolaides, Kypros H., Campbell, James, Campbell, Stuart·1990·American Journal of Obstetrics and Gynecology

DOI 10.1016/0002-9378(90)90378-k

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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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Authors: Van den Hof, M. C., Nicolaides, K. H., Campbell, J., & Campbell, S.
Affiliations: King's College London (GB)
Corresponding author: Nicolaides, Kypros H.
ORCID: Nicolaides, Kypros H.
Campbell, James
Campbell, Stuart
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)
DOI: 10.1016/0002-9378(90)90378-k
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › 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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Evaluation of the lemon and banana signs in one hundred thirty fetuses with open spina bifida

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