Diagnostic value of spinal ultrasound compared to MRI for diagnosis of spinal anomalies in pediatrics

Tawfik, Nermeen A.; Ahmed, Ahmed Tohamy; El-Shafei, Tarek E.; Habba, Mohamed R.

doi:10.1186/s43055-020-0131-7

Cited by 11 publications

(21 citation statements)

References 16 publications

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“…The spinal segment involvement encountered in our study (as forementioned in the results above), were comparably concordant with Tawfik et al [12] and Kommana et al [10] whom both showed that the LSS was the most commonly affected region in 71.1% and 28.5%, followed by the dorsolumbar spine in 17.8% and 21.4%, and the sacrococcygeal spine in 11.1% and 14%, respectively. Whereas Dhingani et al [13] showed that the LSS was the most common involved in 52.6% of patients, followed by the sacrococcygeal spine in 34.2%.…”

Section: Discussionsupporting

confidence: 93%

“…The most common subtypes of SD encountered in our study are presented in Table 2. Both Tawfik et al [12] and Dhingani et al [13] showed comparable similar prevalences of the forementioned CSD subtypes, apart from the mere 6.6% for tethered cord in Tawfik et al [12] as opposed to the compelling 60% in our own cohort.…”

Section: Discussionsupporting

confidence: 78%

“…On the contrary to the Tawfik et al [12], Kommana et al [10], and Dhingani et al [13] studies which included cases of both open and closed SD, we only included cases of CSD to be more precise and since OSD actually requires no imaging.…”

Section: Discussionmentioning

confidence: 99%

“…One specialized radiologist of 5 years' experience in pediatrics cross sectional imaging reviewed all MRI studies, and another specialized radiologist of 8 years' experience in pediatric USG underwent all spinal USG examinations; both were blind to patients' data and to the results of each other. Following Hughes et al [11] and others [12,13], images of both USG and MRI were compared to each other's and the degree of agreement between different findings in both studies were classified into full (where all findings in MRI were identified in USG), partial (some findings in MRI were missed in USG) and no agreement (where all findings of MRI were missed by USG).…”

Section: Study Proceduresmentioning

confidence: 99%

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Role of ultrasonography in screening of spinal dysraphism in infants at risk

Hussein

Ahmed

Osman

et al. 2022

Egypt J Radiol Nucl Med

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Background Spinal dysraphism (SD) encompasses congenital spinal defects that result from inappropriate fusion of the different midline osseous, mesenchymal, and neural elements. The primary tools for diagnosis of SD are both spinal ultrasonography (USG) and magnetic resonance imaging (MRI). Spinal USG is growingly being used as an initial screening modality with sensitivities and accuracies equivalent to those of MRI. Anorectal malformations (ARM) have ultimate association with many other congenital abnormalities, of which spinal dysraphism is one of the most common. The main aim of study was to assess the diagnostic accuracy of spinal USG as a screening modality in comparison with MRI in infants with closed spinal dysraphism. We also endeavored to highlight the associated spinal dysraphism radiological findings in patients with either ARM or back cutaneous stigmata. Results Our prospective diagnostic comparative study included 33 patients, all of whom underwent both MRI and USG. Both MRI and USG showed appreciable agreement in the assessment of spinal dysraphism. In comparison with the gold standard MRI, spinal USG revealed comparable diagnostic metrics: specificity (98.6–100%), sensitivity (66.6–91.6%), PPV (90–100%) and NPV (94.1–98.7%) in diagnosis of different types of spinal dysraphism. The main clinical presentation of nineteen patients was anorectal malformation (ARM), 11 of whom (57.9%) had evidence of associated spinal dysraphism. The most common types of ARM were cloacal malformation, recto-urethral fistula, and rectal atresia with no fistula. On the other hand, sixteen patients were mainly presented with back cutaneous stigmata, 11 of whom (68.8%) had associated spinal dysraphism. The most common presenting cutaneous stigmata were low back swelling and atypical dimples. Conclusion The front-line screening modality for infants with closed SD should be spinal USG, however, its main limitation is the restrained time window in the first 6 months of life. Infants with ARM should be screened for spinal anomalies, especially those with high and complex types. Infants with high-risk back cutaneous stigmata should be similarly screened, as well.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

Role of ultrasonography in screening of spinal dysraphism in infants at risk

Hussein

Ahmed

Osman

et al. 2022

Egypt J Radiol Nucl Med

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“…A lumbar MRI is a better imaging study to detect OSD as it is able to visualize the CM and to assess the thickness of the FT. 5,6,17 However, a lumbar MRI requires sedation or general anesthesia, is expensive and time-consuming, and is usually not performed until after 3-6 months of age when images are more free of micro-motion artifact. In Tawfik et al 18 study of the diagnostic value of spinal US compared to MRI for the diagnosis of pediatric spinal anomalies, they determined that spinal US may be used as a first-line screening tool for spinal dysraphism while an MRI is the best diagnostic modality for older pediatric patients. Furthermore, these authors recommended that patients with an abnormal spinal US should undergo a spinal MRI.…”

Section: Spinal Imaging Uds Neurosurgical Evaluation Tcrmentioning

confidence: 99%

Risk of occult spinal dysraphism based on lumbosacral cutaneous manifestations

et al. 2021

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Objectives: Occult spinal dysraphism is a congenital failure of fusion of the posterior vertebral arches with intact skin overlying the defect. Lumbosacral cutaneous manifestations are associated with a variable risk of occult spinal dysraphism. Tethered cord syndrome is a type of occult spinal dysraphism that puts abnormal traction on the spinal cord. This study analyzed neonates and infants who were referred to our pediatric urology practice and had evidence of lumbosacral cutaneous manifestation on physical examination. Methods: We reviewed the presence of lumbosacral cutaneous manifestations in neonates and infants evaluated in our pediatric urology clinic at our Institution over a 6-year period (1 March, 2015–28 February, 2021) with no prior diagnosis of lumbosacral cutaneous manifestation. All patients underwent a spinal ultrasound. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. A coccygeal pit was statistically marginally higher in abnormal versus normal spinal ultrasound (p = 0.07). Patients with only one lumbosacral cutaneous manifestation (N = 121) were significantly more likely to have a normal spinal ultrasound compared to those with two or more lumbosacral cutaneous manifestation (N = 17) (79% vs 53%, p = 0.03). Conclusion: Due to the varying risk of certain lumbosacral cutaneous manifestations with occult spinal dysraphism, all patients with a lumbosacral cutaneous manifestation should undergo spinal ultrasound. This study also highlights the importance of urodynamic studies when there are abnormal cutaneous findings. Routine physical examinations of the lumbar region for cutaneous manifestations of occult spinal dysraphism are vital to ensure prompt management of tethered cord syndrome and avoid potentially devastating consequences.

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