European journal of radiology · 2026
Tectal plate dysmorphism in atretic cephaloceles: an underrecognized but frequent imaging feature.
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Sahap Seda Kaynak, Atalan Beyza Nur, Fitoz Suat
Аннотация
OBJECTIVE: To systematically evaluate tectal plate morphology in patients with atretic cephaloceles and to determine whether tectal dysmorphism represents an underrecognized imaging feature.
METHODS: In this retrospective study, MRI examinations of 13 pediatric patients with parietal and/or occipital atretic cephaloceles were reviewed. Tectal morphology was assessed on sagittal 3D T1-weighted images for contour, thickness, and the presence of tectal beaking, and the extent of dysmorphic involvement, either the entire tectal plate or selective involvement of the inferior colliculus, was recorded. Associated imaging findings, including venous anomalies, fibrous stalk, CSF cleft, tentorial abnormalities, and additional midline and posterior fossa anomalies, were also evaluated. Descriptive statistics were used for data analysis.
RESULTS: Tectal plate dysmorphism was identified in 8 of 13 patients (61.5%), and 6 of these (75%) demonstrated a tectal beaking configuration. The pattern of involvement included both the entire tectal plate and selective involvement of the inferior colliculus. Persistent falcine sinus was observed in 8 patients (61.5%), occurring in all parietal lesions but in only one isolated occipital lesion. Additional imaging findings included tentorial peaking, observed in all patients (100%), and enlargement of the superior cerebellar cistern in 12 patients (92.3%), along with various midline and posterior fossa anomalies.
CONCLUSION: Tectal dysmorphism is a relatively frequent and underrecognized imaging feature of atretic cephalocele. Its association with venous anomalies and dorsal midline abnormalities suggests a shared developmental background and may provide additional diagnostic value.
METHODS: In this retrospective study, MRI examinations of 13 pediatric patients with parietal and/or occipital atretic cephaloceles were reviewed. Tectal morphology was assessed on sagittal 3D T1-weighted images for contour, thickness, and the presence of tectal beaking, and the extent of dysmorphic involvement, either the entire tectal plate or selective involvement of the inferior colliculus, was recorded. Associated imaging findings, including venous anomalies, fibrous stalk, CSF cleft, tentorial abnormalities, and additional midline and posterior fossa anomalies, were also evaluated. Descriptive statistics were used for data analysis.
RESULTS: Tectal plate dysmorphism was identified in 8 of 13 patients (61.5%), and 6 of these (75%) demonstrated a tectal beaking configuration. The pattern of involvement included both the entire tectal plate and selective involvement of the inferior colliculus. Persistent falcine sinus was observed in 8 patients (61.5%), occurring in all parietal lesions but in only one isolated occipital lesion. Additional imaging findings included tentorial peaking, observed in all patients (100%), and enlargement of the superior cerebellar cistern in 12 patients (92.3%), along with various midline and posterior fossa anomalies.
CONCLUSION: Tectal dysmorphism is a relatively frequent and underrecognized imaging feature of atretic cephalocele. Its association with venous anomalies and dorsal midline abnormalities suggests a shared developmental background and may provide additional diagnostic value.