Abstract
Each case of conjoined twins is unique and poses a challenge for diagnosis and therapy. Only few have anatomy compatible with a viable surgical separation. Accurate multisystem imaging evaluation is required to determine the feasibility of separation. We present a rare case of parapagus conjoined twins who were evaluated by ultrasonography, barium meal follow through, MRI and MR angiography. The single most helpful study was MR and MR angiography performed during simultaneous bolus intravenous Gadolinium injection into both babies, supplying information superior to that obtained with multiple conventional imaging studies. Shared and separate organs as well as vascular anatomy were well delineated by MRI and MR angiography. Unfortunately the complexity of anatomic conjunction in our case precluded surgical separation.
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