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This is a fetal ultrasound performed at

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approximately 22 weeks of gestation.

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We can see here,

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here's the thoracic spine,

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the lumbar spine going down to the sacrum.

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And posteriorly,

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we see this bubble-like projection that extends

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posteriorly and has predominantly

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fluid-like signal within it.

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That is suspicious

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for a lumbosacral myelomeningocele.

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Fetal MRI shows this cystic-like projection,

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and it is not skin-covered.

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We're not seeing skin going over it,

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but we do see neural elements entering it.

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This is actually the caudal

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aspect of the spinal cord.

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So, leading to what's called the neural placode.

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This is a cause of a continuous cerebrospinal

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fluid leak that results in abnormally low

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pressures in the central nervous system

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of the CSF during development.

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And we can see that results in the cerebellum

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taking a configuration where it

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wraps around the brainstem.

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This is the MRI correlate

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on this fetal MRI of something

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referred to on fetal ultrasound

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as a banana sign,

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where this cerebellum looks like a banana

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wrapped around the brainstem.