Developmental disorders

II./3.3.: Radiologic imaging methods of sacral teratoma

II./3.3.1.: X-ray examination

Mainly indirect signs can be seen, such as a large mass displacing the shadow of the pelvic organs, in matured forms calcifications in irregular location which form bones or teeth.

II./3.3.2.: Ultrasound examination

Most common imaging method. Sacrococcygeal teratomas are usually microcystic on the images, including numerous septae  or large cysts with few septae, and the tumor contains solid tissue predominantly. On one part ultrasound imaging can be eye-catching in fetus  on the course of intrauterine examination, on other part definitive diagnosis can be provided by ultrasound. In case of polyhydramnion or oligohydramnion, attention should be payed on additional lesions: hydronephrosis, ascites, hydrops foetus, pleural effusion, skin edema, which indicate an unfavorable outcome especially if placetomegaly is present. Ultrasound can be also helpful in the examination of feeding vessels (by replacing DSA) if the redeveloped, developed branches of the pelvic vessels run to the tumor, and it is drained by serpiginous, dilated efferent veins.

II./3.3.3.: Computed tomography (CT), and angiographic computed tomography (CT angiography)

Both imaging methods show similar images, but both the intrauterine examination and the CT examination of a newborn should be dispensed/replaced (e.g. by MRI) because of the radiation exposure and the contrast material administration.

II./3.3.4.: Magnetic resonance imaging (MR – magnetic resonance; MRI – magnetic resonance imaging)

On MRI examination, teratomas show a very colourful image both on T1 and on T2 weighted images based on its tissue elements and their distribution. (Fat has high signal on T1 weighted image, calcified/osseous elements are signal free on every sequences, whileas fluids, e.g. liquor produced by choroid plexus shows high signal on T2 weighted image.) MRI is the proper method in the imaging of spinal invasion as well. MRI can be very useful in the imaging of local invasion of malignant (unmatured) forms.