Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

AIMS: The present study aimed to determine whether yolk sacs with abnormal sonographic appearance are associated with adverse perinatal outcomes in both early and late gestation. MATERIAL AND METHODS: A total of 305 viable singleton pregnancies with gestational age of 6 to 9 weeks were prospectively evaluated with respect to perinatal outcomes and sonographic characteristics of the yolk sacs. RESULTS: An abnormal yolk sac was found in 66 pregnancies. In pregnancies with enlarged yolk sacs a miscarriage occurred in 37.5% of cases (3/8). The pregnancies with a yolk sac diameter >/= 5 mm had a significantly higher risk of miscarriage (p = 0.005). The risk of miscarriage was statistically similar between the pregnancies with regular and those with irregular yolk sacs (p = 0.73). Miscarriage occurred in 3.8% of pregnancies with irregular yolk sacs (2/52) and none of pregnancies with echogenic yolk sacs (0/6). Adverse perinatal outcomes were not associated with either irregular or echogenic yolk sacs. CONCLUSIONS: An enlarged yolk sac visualized before the 7th week of gestation is strongly associated with a significantly increased risk for spontaneous miscarriage. The presence of an echogenic or irregular yolk sac appears to be unrelated to adverse perinatal outcome.

Evaluation of labyrinthine fistula by MR cisternography.

Sensorineural hearing loss (SNHL) can develop after trauma and determination of its etiology is crucial for treatment planning. Computed tomography (CT) is the first-line imaging method in evaluation of trauma victims; however, its value is limited in visualization of perilymphatic fistula or in assessment of cochlear implant candidates. Herein, we present imaging findings of a patient with traumatic bilateral transverse fractures of temporal bones and resultant SNHL. This patient had a fistula between inner ear and subarachnoid space which was detected at non-contrast-enhanced MR cisternography (NCE-MRC) and contrast-enhanced MR cisternography (CE-MRC) scans. To the best of our knowledge, this is the first case in the literature. In conclusion, in patients with transverse fractures of temporal bone, in presence of otic capsule involvement at CT images, the inner ear structures and surrounding organs should be carefully evaluated via NCE-MRC. In case of a suspicion of a fistula, CE-MRC can help in early diagnosis and can also help to visualize the leakage location, which is of paramount importance for correct treatment and management of such cases.