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Fetal megacystis: differential diagnosis.
[megacystis-microcolon-intestinal hypoperistalsis syndrome]
The
purpose
of
our
retrospective
observational
series
was
to
determine
whether
the
sonographic
characteristics
of
fetal
megacystic
bladders
can
be
used
to
reliably
establish
the
most
likely
diagnosis
in
fetuses
with
this
condition
.
The
sonographic
records
of
pregnant
patients
referred
to
our
institutions
over
a
10
-
year
period
who
were
found
on
initial
2
-
dimensional
sonography
to
be
carrying
fetuses
with
megacystis
were
examined
for
evidence
of
a
keyhole
sign
,
bladder
thickness
,
amniotic
fluid
index
,
and
fetal
sex
.
When
available
,
3
-
/
4
-
dimensional
sonography
,
Doppler
angiography
,
tomographic
ultrasound
imaging
,
virtual
organ
computer-aided
analysis
,
and
automatic
volume
calculation
were
used
as
part
of
the
detailed
fetal
anatomic
survey
.
Twenty
fetuses
with
megacystis
were
identified
.
Seventeen
were
male
;
2
were
female
;
and
1
had
ambiguous
genitalia
.
All
male
fetuses
with
megacystis
originally
had
a
diagnosis
of
prune
belly
syndrome
.
The
diagnosis
for
10
male
fetuses
with
a
keyhole
sign
was
changed
to
megacystis
secondary
to
posterior
urethral
valves
.
The
fetus
with
ambiguous
genitalia
had
prune
belly
syndrome
.
One
of
the
female
fetuses
had
a
diagnosis
of
urethral
atresia
,
and
the
diagnosis
for
the
other
female
fetus
was
megacystis-
microcolon
-
intestinal
hypoperistalsis
syndrome
.
In
conclusion
,
in
fetuses
with
megacystic
bladders
,
it
is
possible
to
distinguish
between
cases
with
prune
belly
syndrome
,
posterior
urethral
valves
,
urethral
atresia
,
and
megacystis-
microcolon
-
intestinal
hypoperistalsis
syndrome
by
a
detailed
anatomic
survey
using
2
-
and
3
-
/
4
-
dimensioinal
sonographic
techniques
.
Diseases
Validation
Diseases presenting
"urethral atresia"
symptom
megacystis-microcolon-intestinal hypoperistalsis syndrome
This symptom has already been validated