Abstract
The term cloacal malformation is commonly used to describe the classic cloacal malformation where there is a single common urogenital and intestinal channel located at the expected site of the urethra. There is, however, a spectrum of cloacal abnormalities that differ from this classic type and are less well discussed in the radiologic and surgical literature. The aim of this pictorial essay is to familiarize radiologists with the anatomy, appropriate terminology and key prenatal imaging findings that differentiate the six entities that constitute the spectrum of cloacal abnormalities.
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05 April 2019
The published version of this article unfortunately contained a mistake. Author name Mariana Z. Meyers was incorrect. The correct middle initial is given above.
References
Gupta A, Bischoff A, Peña A et al (2014) The great divide: septation and malformation of the cloaca, and its implications for surgeons. Pediatr Surg Int 30:1089–1095
Taori K, Krishnan V, Sharbidre KG et al (2010) Prenatal sonographic diagnosis of fetal persistent urogenital sinus with congenital hydrocolpos. Ultrasound Obstet Gynecol 36:641–643
Winkler NS, Kennedy AM, Woodward PJ (2012) Cloacal malformation: embryology, anatomy, and prenatal imaging features. J Ultrasound Med 31:1843–1855
Jo Mauch T, Albertine KH (2002) Urorectal septum malformation sequence: insights into pathogenesis. Anat Rec 268:405–410
Williams DH 4th, Fitchev P, Policarpio-Nicolas ML et al (2005) Urorectal septum malformation sequence. Urology 66:657
Pyati UJ, Cooper MS, Davidson AJ et al (2006) Sustained bmp signaling is essential for cloaca development in zebrafish. Development 133:2275–2284
Gupta A, Bischoff A (2016) Pathology of cloaca anomalies with case correlation. Semin Pediatr Surg 25:66–70
Qureshi F, Jacques SM, Yaron Y et al (1998) Prenatal diagnosis of cloacal dysgenesis sequence: differential diagnosis from other forms of fetal obstructive uropathy. Fetal Diagn Ther 13:69–74
Banu T, Chowdhury TK, Hoque M, Rahman MA (2013) Cloacal malformation variants in male. Pediatr Surg Int 29:677–682
Livingston JC, Elicevik M, Breech L et al (2012) Persistent cloaca: a 10-year review of prenatal diagnosis. J Ultrasound Med 31:403–407
Escobar LF, Weaver DD, Bixler D et al (1987) Urorectal septum malformation sequence. Report of six cases and embryological analysis. Am J Dis Child 141:1021–1024
Clavelli A, Ahielo H, Watman E, Ota A Persistent urogenital sinus Available from https://sonoworld.com/Fetus/page.aspx?id=1275
Peña A, Bischoff A (2015) Surgical treatment of colorectal problems in children. Springer International Publishing, Switzerland
Warne S, Chitty LS, Wilcox DT (2002) Prenatal diagnosis of cloacal anomalies. BJU Int 89:78–81
Kline-Fath BM, Bulas DI, Bahado-Singh R (eds) (2015) Fetal imaging: ultrasound and MRI. Wolters Kluwer Health, Philadelphia
Moon MH, Cho JY, Kim JH et al (2010) In-utero development of the fetal anal sphincter. Ultrasound Obstet Gynecol 35:556–559
Le Borgne H, Philippe HJ, Le Vaillant C (2011) Contribution of three-dimensional ultrasonography in depicting perineal features in cloacal malformation. Fetal Diagn Ther 30:239–240
Vijayaraghavan SB, Prema AS, Suganyadevi P (2011) Sonographic depiction of the fetal anus and its utility in the diagnosis of anorectal malformations. J Ultrasound Med 30:37–45
Rubesova E (2012) Fetal bowel anomalies--US and MR assessment. Pediatr Radiol 42:S101–S106
Saguintaah M, Couture L, Veyrac C (2002) MRI of the fetal gastrointestinal tract. Pediatr Radiol 32:395–404
Jerdee T, Newman B, Rubesova E (2015) Meconium in perinatal imaging: associations and clinical significance. Semin Ultrasound CT MR 36:161–177
Rubesova E, Vance CJ, Ringertz HG (2009) Three-dimensional MRI volumetric measurements of the normal fetal colon. AJR Am J Roentgenol 192:761–765
Calvo-Garcia MA, Kline-Fath BM, Levitt MA et al (2011) Fetal MRI clues to diagnose cloacal malformations. Pediatr Radiol 41:1117–1128
Levitt MA, Stein DM, Peña A (1998) Gynecologic concerns in the treatment of teenagers with cloaca. J Pediatr Surg 33:188–193
Manzella A, Filho PB (1998) Hydrocolpos, uterus didelphys and septate vagina in association with ascites: antenatal sonographic detection. J Ultrasound Med 17:465–468
Chen CP, Chang TY, Hsu CY et al (2012) Persistent cloaca presenting with a perineal cyst: prenatal ultrasound and magnetic resonance imaging findings. J Chin Med Assoc 75:190–193
Pena A, Bischoff A, Breech L et al (2010) Posterior cloaca - further experience and guidelines for the treatment of an usual anorectal malformation. J Pediatr Surg 45:1234–1240
Bischoff A, Levitt MA, Lim FY et al (2010) Prenatal diagnosis of cloacal malformations. Pediatr Surg Int 26:1071–1075
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Dannull, K.A., Browne, L.P. & Meyers, M.Z. The spectrum of cloacal malformations: how to differentiate each entity prenatally with fetal MRI. Pediatr Radiol 49, 387–398 (2019). https://doi.org/10.1007/s00247-018-4302-x
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DOI: https://doi.org/10.1007/s00247-018-4302-x