Ultrasonographic Diagnosis of Diastematomyelia During the 14th Week of Gestation

Prenatal Diagnosis of Diastematomyelia: a Case Report and Literature Review

Diastematomyelia is a type of closed spinal dysraphism in which there is splitting of the spinal cord. It is a rare entity that accounts for less than 3% of closed spinal dysraphisms and affects females 1.3 to 6 times more frequently than males. Lesions are usually found in the lower thoracic and upper lumbar regions. It is characterised by two hemicords separated by a bony or cartilaginous spur. In most cases, it is an isolated malformation with a favourable prognosis. However, it may be associated with other abnormalities and sonography is the imaging test par excellence for early prenatal diagnosis. We report a case of diastematomyelia diagnosed by prenatal sonography at 24 weeks' gestation. Amniotic fluid alpha-fetoprotein (AF-AFP) was normal, while amniotic fluid acetylcholinesterase (AF-AChE) was positive. After birth, the diagnosis was confirmed with magnetic resonance imaging (MRI). The anomaly was associated with a spinal lipoma, tethered cord and dermal sinus. A review of all the cases described in the literature to date is carried out.

MRI Characteristics of Split Cord Malformation

Split cord malformation (SCM), a subtype of spinal dysraphism, represents a rare entity of congenital malformation in the spine that occurs rarely in adults. SCM commonly presents with back pain. MRI is the gold standard for diagnosis. We report a case of a previously healthy 25-year-old woman who presented with lower back pain for a duration of 6 months. MRI confirmed a diagnosis of type I SCM. This case highlights the neuroimaging characteristics of SCM, although it might remain asymptomatic for many years. Surgical intervention might not be indicated in case of absent clinical complications.

Prenatal diagnosis of fetal hemivertebra in the first trimester

Hemivertebra is a congenital spinal abnormality. The condition may affect one or multiple vertebrae. Hemivertebra occurs because of malformations or absence of the ossification centers. Most cases reported in the literature are diagnosed in the second trimester, usually after 22 weeks. It is very unusual and difficult for the hemivertebra to be detected at the first trimester.

The Clinical Value of Prenatal 3D Ultrasonic Diagnosis on Fetus Hemivertebra Deformity- A Preliminary Study

Objective:

The present study is planned to discuss the clinical value of prenatal 3D ultra-sonic diagnosis on fetus hemivertebra deformity through the retrospective analysis of clinical data of fetus hemivertebra deformity.

Methods:

Selected 9 fetus hemivertebra deformity cases, which have been admitted to our hospital during the period from January, 2010 to January, 2016 as study samples, and analyzed their 2D and 3D ultrasonic examination data.

Results:

4 cases of the fetus hemivertebra deformity occurred at lumbar vertebra, 3 cases at thoracic vertebra, and 2 cases at thoracolumbar vertebra. There were scoliosis and opened spine bifida (OSB). In 7 cases, there was absence of ribs in fetus. The 2D ultrasonic image showed that: The echo at the center of fetus vertebral arch lesion was blurred or lost. The coronal section showed the deformity of the spine. There was obvious loss of the ossification center. From the cross section, we could see that the vertebral body of the fetus was shrinking and the edges were relatively blurred. The 3D ultrasonic image showed that: the echo at the ossification center of the fetus vertebra was relatively blurred, or even lost. The image also indicated scoliosis deformity of the spine. The vertebral body lesion could be accurately located.

Conclusion:

9 cases of fetus hemivertebra deformity have been detected through examination. Labor inductions have been carried out after getting the permission from the family members. The X-ray examination of the fetus after labor induction showed that the diagnosis was correct. Prenatal ultra-sonic examination holds strong potential for the diagnosis of fetus hemivertebra deformity quite early and deserves further clinical evaluation with large sample size.

The Value of Prenatal Ultrasonographic Diagnosis of Diastematomyelia

OBJECTIVES

To evaluate the value of prenatal ultrasonographic diagnosis of diastematomyelia, and to provide a basis for the diagnosis and differential diagnosis of fetal diastematomyelia.

METHODS

Four fetuses with suspected diastematomyelia based on prenatal ultrasonography are presented. Detailed prenatal ultrasonography was performed to examine spinal cord abnormalities. The region of interest-based spine sagittal plane was defined and 3D volumetric scans were performed, as needed. Images were stored and compared with MRI or ultrasonographic images after abortion.

RESULTS

In the four cases of diastematomyelia diagnosed by prenatal ultrasonography, two were confirmed by MRI after birth, and the other two were confirmed by autopsy and pathologic examination after abortion. Varying degrees of spine or spinal cord deformities were noted. Two pregnancies were terminated, and two newborns underwent surgery.

CONCLUSIONS

Prenatal ultrasonography contributes to the diagnosis of diastematomyelia and provides a basis for prenatal counseling and prognosis.

Prenatal diagnosis of diastematomyelia: a case report and review of the literature

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks' gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.

Prenatal diagnosis of fetal hemivertebra at 20 weeks' gestation with literature review

Hemivertebra is a rare congenital spinal malformation, where only one side of the vertebral body develops, resulting in deformation of the spine, such as scoliosis, lordosis, or kyphosis. We present the ultrasonographic features of a fetus with hemivertebra at 20 weeks’ gestation confirmed by post mortem radiography and pathological examination. The prenatal literature on this disorder is also reviewed. Useful background information is provided for both clinicians and other health professionals who are not familiar with this condition.