Ultrasonography and magnetic resonance imaging evaluation of pediatric spinal anomalies

Abstract

Context:Spinal dysraphisms are congenital abnormalities of the spine due to imperfect fusion of midline mesenchymal, bony and neural structures. Imaging plays a vital role in their evaluation as significant portion of patients may present with concurrent anomalies that need to be corrected simultaneously to avoid repeat surgeries.Aims:The aims of the study were to evaluate Spinal dysraphisms using USG and MRI and to correlate imaging findings with operative findings in patients undergoing surgery.Settings and Design:Hospital based observational study conducted over a period of year.Materials and Methods:38 cases of both sexes and below 12 years of age with spinal dysraphism were studied. USG was performed in 29 cases where acoustic window was available for proper evaluation. MRI was performed in all cases. USG findings were compared with MRI findings and operative follow up was taken in 23 cases who underwent operative management.Statistical Analysis Used:Results were analysed using percentage and arithmetic mean.Results:39.47 % cases were male and 60.53 % cases were female. Neonatal period was the most common presenting age group. Closed spinal dysraphism (63.16%) was more common than open (36.84%). 79.31% cases showed full agreement between spinal USG and MRI examinations and 6 out of 20.69% showed partial agreement. On operative correlation, USG findings were confirmatory in 91.30% cases and MRI findings were confirmatory in 100% cases.Conclusions:USG can be used as the initial modality for evaluation of spinal dysraphism as well as for screening of suspected cases. MRI is indicated to confirm abnormal USG findings, which shows all concurrent abnormalities and also provides additional anatomical details relevant to surgical planning.

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

“…We shared comparable results with Dhingani et al who found that the lumbosacral spine was the most commonly involved spinal segment found in 52.63% of patients, followed by sacrococcygeal region (34.21%) [17].…”

“…Our study results as regards spinal ultrasound are comparable with study by Dhingani et al which showed that the most common anomaly was tethered cord seen in 23 (79.31%) patients, syrinx (62.06%), MMC (48.27%), and lipomyelomeningeocele (27.58%) [17]. And another study by Taahira Nishtar et al, which revealed that 2 of the studied 53 patients (4%) has diastematomyelia [18].…”

“…We agreed with Dhingani et al's study which showed that 23 out of 29 patients (79.31%) showed full agreement between spinal USG and MRI examinations, and 6 out of 29 patients (20.69%) showed partial agreement. In these six cases with partial agreement; spinal USG missed tethered cord and syrinx in three cases, small lipomatous component in one case of lipomyelomeningeocele, one case of intradural lipoma, and one case of split cord associated with myelomeningocele [17].…”

“…It was found that 26.32% of patients with closed SD had subcutaneous mass, and 14 patients (36.84%) were not having subcutaneous mass. In open SD, myelomeningocele was the most common anomaly accounting for 14 (36.84%) cases [17].…”

“…84.21% patients were < 10 years old, and the neonatal period was the most common presenting age group accounting for 39.47% of total cases. The most common clinical finding at presentation was also midline back swelling (60.53%); however, the next common finding was urinary incontinence (47.37%), followed by skin dimple in back (28.95%), fecal incontinence (21.05%), hair tuft (3.33%), and dermal sinus (3.33%) [17]. In our study, lumbosacral spine was the most common region involved in 32 patients (71.1%).…”