Abnormalities of the Fetal Central Nervous System: Prenatal US Diagnosis with Postnatal Correlation.

Fetal central nervous system (CNS) abnormalities are second only to cardiac malformations in their frequency of occurrence. Early and accurate diagnosis at prenatal US is therefore essential, allowing improved prenatal counseling and facilitating appropriate referral. Thorough knowledge of normal intracranial anatomy and adoption of a logical sonographic approach can improve depiction of abnormal findings, leading to a more accurate differential diagnosis earlier in pregnancy. Four standard recommended views-transventricular, falx, cavum, and posterior fossa or transcerebellar views-provide an overview of fetal intracranial anatomy during the second trimester anatomy scan. Essential elements surveyed in the head and neck include the lateral cerebral ventricles, choroid plexus, midline falx, cavum septi pellucidi, cerebellum, cisterna magna, upper lip, and nuchal fold. CNS abnormalities can be organized into six main categories at prenatal US. Developmental anomalies include neural tube defects and neuronal migration disorders. Posterior fossa disorders include Dandy-Walker malformation variants and Chiari II malformation. Ventricular anomalies include aqueductal stenosis. Midline disorders include those on the spectrum of holoprosencephaly, agenesis of the corpus callosum, and septo-optic dysplasia. Vascular anomalies include vein of Galen malformations. Miscellaneous disorders include hydranencephaly, porencephaly, tumors, and intracranial hemorrhage. Correlation with postnatal MRI is helpful for confirmation and clarification of suspected diagnoses after birth. The authors discuss a standard US imaging approach to the fetal CNS and review cases in all categories of CNS malformations, providing postnatal MRI correlation when available.©RSNA, 2020.

Differential Motivations for Pursuing Diagnostic Radiology by Gender: Implications for Residency Recruitment.

RATIONALE AND OBJECTIVES: The purpose of this study is to determine how the motivations to pursue a career in radiology differ by gender. In addition, the influence of medical school radiology education will be assessed. MATERIALS AND METHODS: Radiology applicants to our institution from the 2015-2016 interview season were offered an online survey in February 2016. Respondents scored the influence of 24 aspects of radiology on their decision to pursue radiology. Comparisons were made between male and female respondents. Respondents were also asked the type of medical school radiology education they received and to score the influence this experience had on their decision to pursue radiology. RESULTS: There were 202 total respondents (202/657) including 47 women and 155 men. Compared to men, the following factors had a more negative impact on women: flexible work hours (P = 0.04), work environment (P = 0.04), lifestyle (P = 0.04), impact on patient care (P = 0.05), high current debt load (P = 0.02), gender distribution of the field (P = 0.04), and use of emerging/advanced technology (P = 0.02). In contrast, women felt more favorably about the opportunities for leadership (P = 0.04) and research (P < 0.01). Dedicated radiology exposure was as follows: 20% (n = 20) none, 48% (n = 96) preclinical exposure, 55% (n = 111) elective rotation, and 18% (n = 37) core rotation. More intensive radiology exposure via a core rotation had a significantly positive impact on the decision to pursue radiology (P < 0.01). CONCLUSIONS: Male and female radiology applicants are motivated by different aspects of radiology, which may influence residency recruitment practices. In addition, more intensive radiology exposure has a net positive impact on the decision to pursue radiology.