Cystic Hygroma in 4D Scan
- Single or multiple cysts within the soft tissues, usually involving the neck.
- They are frequently in association with chromosomal defects (68%) especially with Turner’s syndrome.
- Demonstration of typical honeycomb multiple septate cystic structures usually located in the occipito-cervical region is the clue for diagnosis.
Large lesions show other anatomic defects or signs of non-immune hydrops. Chromosomal study is mandatory for further and final diagnosis.
There is a massive septated cyst, fluid filled, located along the posterior cervical line and extending proximally to cover the occiput, vertex and frontal area and distally to the thoracic area.
The lesion is due to cervical lymphatic obstruction with failure of communication with the jugular venous system.
The sequence of obstruction are:
1- Generalized skin edema,
2- Pleural effusion and lung hypoplasia,
3- Pericardial effusion and
There is a high association with:
1- Fetal monosomy (xo), trisomy 18, 13, 21, and XXY chromosomal pattern.
2- Cardiac, renal and skeletal defects.
The longitudinal scan shows:
- Scalp edema.
- Skin edema.
- Increased nuchal fold thickening with septations.
- Normal Spine.
- Hypoplastic chest.