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Case Reports in Radiology
Volume 2012 (2012), Article ID 564036, 4 pages
http://dx.doi.org/10.1155/2012/564036
Case Report

Multimodality Imaging in the Assessment of Thoraco-Omphalopagus Conjoined Twin: Lessons to Learn

1Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 53000 Kuala Lumpur, Malaysia
2Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
3Pediatric Surgical Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
4Department of Pediatrics, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia

Received 21 March 2012; Accepted 23 May 2012

Academic Editors: R. Dammers and S. Yalcin

Copyright © 2012 Kanaga Kumari Chelliah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Conjoined twins are rare and present a unique challenge to pediatric surgeons and radiologists. An imaging strategy to accurately define anatomic fusion, vascular anomalies, and other associated abnormalities is important for surgical planning and prognostic information. A conjoined female twin with a combined weight of 2.8 kg was born by emergency caeserean. Hence, a computed tomography scan of the thorax and entire abdomen at 1.25 mm slice thickness was performed to delineate the internal structures of the twins. CT-angiography defined specific vascular supply which determined the distribution of shared structures between the twins. An echocardiogram showed four heart chambers with atrioventricular septal defect. To further evaluate the heart chambers, the twin was planned for gated cardiac magnetic resonance imaging. Unfortunately, they succumbed 6 hours apart due to complication of septicemia. Magnetic resonance imaging and CT scan provide excellent anatomic detail, demonstrating organ position, shared viscera, and limited vascular anatomy, whilst angiography defined specific vascular supply, useful in determining the distribution of shared structures between the twins in planning for surgery.