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Balani A, Sidpra J, Sudhakar S, Biswas A, Öztekin Ö, Capra V, Catala M, Copp AJ, Kumar N, Johal N, Tahir MZ, Thompson D, Pang D, Mirsky DM, Ho ML, Huisman TAGM, Rossi A, Mankad K. International Consensus Statement on the Radiological Evaluation of Dysraphic Malformations of the Spine and Spinal Cord. AJNR Am J Neuroradiol 2024; 45:ajnr.A8117. [PMID: 38360788 PMCID: PMC11288609 DOI: 10.3174/ajnr.a8117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/13/2023] [Indexed: 02/17/2024]
Abstract
Dysraphic malformations of the spine and spinal cord (DMSSC) represent a spectrum of common congenital anomalies typically (though not exclusively) affecting the lower spinal segments. These may be responsible for varying degrees of neurologic, orthopedic, and urologic morbidity. With advances in neuroimaging, it is now possible to better diagnose and evaluate these disorders both prenatally and postnatally. Neuroimaging, performed at the right time and with technique optimization, is integral in guiding clinical management. However, the terminology used to describe these lesions has become increasingly confusing, and there is a lack of consensus regarding the essential radiologic features and their clinical weighting. This variability in radiologic practice risks unstructured decision making and increases the likelihood of suboptimal, less informed clinical management. In this manuscript, the first of a series of consensus statements, we outline a standardized international consensus statement for the radiologic evaluation of children with suspected DMSSC derived from a critical review of the literature, and the collective clinical experience of a multinational group of experts. We provide recommendations for plain radiography, sonography, CT, and MR imaging in the evaluation of DMSSC with an emphasis on technique of imaging and imaging protocols.
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Affiliation(s)
- Ankit Balani
- From the Department of Neuroradiology (A. Balani, J.S., S.S., A. Biswas, K.M.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jai Sidpra
- From the Department of Neuroradiology (A. Balani, J.S., S.S., A. Biswas, K.M.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Developmental Biology and Cancer Section (J.S., A.J.C., K.M.), University College London Great Ormond Street Institute of Child Health, London, UK
| | - Sniya Sudhakar
- From the Department of Neuroradiology (A. Balani, J.S., S.S., A. Biswas, K.M.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Asthik Biswas
- From the Department of Neuroradiology (A. Balani, J.S., S.S., A. Biswas, K.M.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Özgür Öztekin
- Department of Neuroradiology (Ö.Ö.), Izmir Bakircay University, Izmir, Turkey
| | - Valeria Capra
- Medical Genetics Unit (V.C.), IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Martin Catala
- Laboratoire de Biologie du Développement (M.C.), UMR 7622 de Sorbonne Université et du CNRS, ERL 1156 de l'INSERM et Institut de Biologie Paris Seine, Paris, France
| | - Andrew J Copp
- Developmental Biology and Cancer Section (J.S., A.J.C., K.M.), University College London Great Ormond Street Institute of Child Health, London, UK
| | - Neetu Kumar
- Department of Urology (N.K., N.J.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Navroop Johal
- Department of Urology (N.K., N.J.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - M Zubair Tahir
- Department of Neurosurgery (M.Z.T., D.T., D.P.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Dominic Thompson
- Department of Neurosurgery (M.Z.T., D.T., D.P.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Dachling Pang
- Department of Neurosurgery (M.Z.T., D.T., D.P.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Department of Paediatric Neurosurgery (D.P.), University of California, Davis, Davis, California
| | - David M Mirsky
- Department of Radiology (D.M.M.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Mai-Lan Ho
- Department of Radiology (M.-L.H.), Nationwide Children's Hospital, Ohio State University, Columbus, Ohio
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology (T.A.G.M.H.), Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Andrea Rossi
- Neuroradiology Unit (A.R.), IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Health Sciences (A.R.), University of Genoa, Genoa, Italy
| | - Kshitij Mankad
- From the Department of Neuroradiology (A. Balani, J.S., S.S., A. Biswas, K.M.), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Developmental Biology and Cancer Section (J.S., A.J.C., K.M.), University College London Great Ormond Street Institute of Child Health, London, UK
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Inarejos Clemente EJ, Navallas Irujo M, Navarro OM, Salas Flores B, Sousa Cacheiro P, Ladera E, Rebollo Polo M, Tijerín Bueno M, Barber Martínez de la Torre I. US of the Spine in Neonates and Infants: A Practical Guide. Radiographics 2023; 43:e220136. [PMID: 37141137 DOI: 10.1148/rg.220136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Emilio J Inarejos Clemente
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - María Navallas Irujo
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Oscar M Navarro
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Bárbara Salas Flores
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Paulino Sousa Cacheiro
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Enrique Ladera
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Mónica Rebollo Polo
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Marta Tijerín Bueno
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
| | - Ignasi Barber Martínez de la Torre
- From the Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Av Sant Joan de Déu 2, 08950 Barcelona, Spain (E.J.I.C., M.N.I., B.S.F., P.S.C., E.L., M.R.P., I.B.M.d.l.T.); Department of Medical Imaging, University of Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital Universitario San Agustín, Avilés, Spain (M.T.B.)
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Dell'Apa D, Fumeo M, Volta A, Bernardini M, Fidanzio F, Buffagni V, Christen M, Jagannathan V, Leeb T, Bianchi E. Case report: Sacral agenesis in two boxer dogs: clinical presentation, diagnostic investigations, and outcome. Front Vet Sci 2023; 10:1201484. [PMID: 37303726 PMCID: PMC10248164 DOI: 10.3389/fvets.2023.1201484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Two boxer dogs from the same litter were presented at 3 months of age for urinary and fecal incontinence. Both dogs had an abnormal tail consisting of a small stump, an atonic anal sphincter, and absent perineal reflex and sensation. Neurological evaluation was indicative of a lesion of the cauda equina or sacral spinal cord. Radiology and CT scan of the spine displayed similar findings in the two dogs that were indicative of sacral agenesis. Indeed, they had 6 lumbar vertebrae followed by a lumbosacral transitional vertebra, lacking a complete spinous process, and a hypoplastic vertebra carrying 2 hypoplastic sacral transverse processes as the only remnant of the sacral bone. Caudal vertebrae were absent in one of the dogs. On MRI, one dog had a dural sac occupying the entire spinal canal and ending in a subfascial fat structure. In the other dog, the dural sac finished in an extracanalar, subfascial, well-defined cystic structure, communicating with the subarachnoid space, and consistent with a meningocele. Sacral agenesis-that is the partial or complete absence of the sacral bones-is a neural tube defect occasionally reported in humans with spina bifida occulta. Sacral agenesis has been described in human and veterinary medicine in association with conditions such as caudal regression syndrome, perosomus elumbis, and Currarino syndrome. These neural tube defects are caused by genetic and/or environmental factors. Despite thorough genetic investigation, no candidate variants in genes with known functional impact on bone development or sacral development could be found in the affected dogs. To the best of the authors' knowledge, this is the first report describing similar sacral agenesis in two related boxer dogs.
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Affiliation(s)
- Diletta Dell'Apa
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Martina Fumeo
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Antonella Volta
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Marco Bernardini
- Neurodiagnostic Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
- Department of Animal Medicine, Production and Health, Clinical Section, University of Padua, Legnaro, Italy
| | | | | | - Matthias Christen
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Vidhya Jagannathan
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Tosso Leeb
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Ezio Bianchi
- Department of Veterinary Science, University of Parma, Parma, Italy
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Khalatbari H, Perez FA, Lee A, Shaw DW. Rapid Magnetic Resonance Imaging of the Spine in Neonates with Spinal Dysraphism. World Neurosurg 2020; 144:e648-e659. [DOI: 10.1016/j.wneu.2020.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
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Unveiling the tale of the tail: an illustration of spinal dysraphisms. Neurosurg Rev 2019; 44:97-114. [PMID: 31811517 DOI: 10.1007/s10143-019-01215-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/31/2019] [Accepted: 11/20/2019] [Indexed: 01/15/2023]
Abstract
Spinal dysraphism is an umbrella term describing herniation of meninges or neural elements through defective neural arch. They can be broadly categorized into open and closed types. MRI is the investigation of choice to study neural abnormalities and to assess the severity of hydrocephalus and Chiari malformation. Knowledge of the embryology of these disorders is valuable in correctly identifying the type of dysraphism. The aim of surgery is untethering and dural reconstruction. Accurate depiction of the abnormal anatomy in cases of spinal dysraphism is of utmost importance for surgical management of these patients. MRI makes this possible due to its excellent soft tissue contrast resolution and multiplanar capability, allowing the radiologist to evaluate the intricate details in small pediatric spinal structures. Imaging enlightens the surgeons about the status of spinal cord and other associated abnormalities and helps detect re-tethering in operated cases. Besides, antenatal surgery to repair myelomeningoceles has made detection of open dysraphisms on fetal MRI and antenatal ultrasound critical. The purpose of this review is to describe the development of spine, illustrate the myriad imaging features of open and closed spinal dysraphisms, and enlist the reporting points the operating surgeon seeks from the radiologist.
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Orman G, Tijssen MP, Seyfert D, Gassner I, Huisman TA. Ultrasound to Evaluate Neonatal Spinal Dysraphism: A First‐Line Alternative to CT and MRI. J Neuroimaging 2019; 29:553-564. [DOI: 10.1111/jon.12649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gunes Orman
- Edward B. Singleton Department of RadiologyTexas Children's Hospital and Baylor College of Medicine Houston TX
| | - Maud P.M Tijssen
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
- Department of RadiologyMaastricht University Medical Center Maastricht The Netherlands
| | - Donna Seyfert
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
| | - Ingmar Gassner
- Department of RadiologyInnsbruck Medical University Innsbruck Austria
| | - Thierry A.G.M. Huisman
- Edward B. Singleton Department of RadiologyTexas Children's Hospital and Baylor College of Medicine Houston TX
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
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Cho HH, Lee SM, You SK. Optimal Timing of Spinal Ultrasound Evaluations for Sacral Dimples in Neonates: Earlier May Not Be Better. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1241-1247. [PMID: 30208241 DOI: 10.1002/jum.14803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES A spinal ultrasound (US) evaluation during the immediate postnatal period may have limited ability in evaluating filum thickness because of the spinal cord pulsation caused by a crowded subarachnoid space and the cerebrospinal fluid deficiency during this period. This study aimed to determine the optimal timing of spinal US to evaluate sacral dimples in neonates. METHODS This study included 585 neonates who had a clinically suspicious sacral dimple and underwent spinal US examinations between January 2015 and August 2017. Patients were classified into 1 of 2 groups based on whether measurements of all parameters were possible (group A) or not (group B). Neonatal and maternal clinical factors, including the antenatal history and US parameters, were compared between groups. RESULTS Group A included 443 patients, and group B included 82. Patients in group B were significantly younger (6.2 versus 31.0 days), had a younger corrective age (38.9 versus 42.5 weeks), and had a smaller body weight (3.1 versus 4.6 kg) than those in group A (all P < .005). However, no statistically significant differences were found in other patient or maternal factors (P > .05 for all). The pulsation of the conus medullaris and nerve roots of the cauda equina (14.6% versus 100%), thickening and echogenicity of the filum terminale (2.4% versus 100%), and the presence of a normal subarachnoid space (18.3% versus 100%) were significantly more difficult to detect in group B than in group A (all P < .001). CONCLUSIONS For an accurate evaluation, which can reduce unnecessary confusion and costs, spinal US can be delayed until neonates grow beyond 31 days, with a corrected age of older than 42.5 weeks and body weight of greater than 4.6 kg.
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Affiliation(s)
- Hyun-Hae Cho
- Department of Radiology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - So Mi Lee
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Sun Kyoung You
- Department of Radiology, Chungnam National University Hospital, Daejeon, Korea
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Ishibashi S, Tajima Y, Nakada S, Ota Y, Manako J, Ago M, Shibata N, Taketani T, Kumori K. Sacrococcygeal teratoma with spinal canal invasion. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ausili E, Maresca G, Massimi L, Morgante L, Romagnoli C, Rendeli C. Occult spinal dysraphisms in newborns with skin markers: role of ultrasonography and magnetic resonance imaging. Childs Nerv Syst 2018; 34:285-291. [PMID: 29075839 DOI: 10.1007/s00381-017-3638-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/17/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this paper is to investigate occult spinal dysraphisms (OSD) using lumbar ultrasonography (LUS) in newborns presenting with specific skin markers or sacrococcygeal dimple. METHOD From 2012 to 2015, we performed LUS in newborns with cutaneous stigmata and/or sacroccygeal dimple. Magnetic resonance imaging (MRI) was performed in all patients with abnormal ultrasound or features of neurological involvement in order to detect spinal lesions. RESULTS We prospectively evaluated 475 newborns who presented cutaneous stigmata performing LUS during their 4 weeks of life though 439 completed the study. All patients had a follow-up of almost 12 months. Of these, 39 presented abnormal ultrasonography and underwent MRI. In this group, spinal dysraphism was confirmed in 12 patients. When considering skin markers, dermal sinus correlated with higher risk of spinal cord lesions, on the other hand the presence of simple sacral dimple alone denoted a very low risk of occult spinal dysraphism. The simultaneous presence of more skin markers and/or the presence of lumbar ultrasonography abnormality regarding the level of the conus, pulsatility, and the position of the cord, thickness of the filum terminale, or the presence of an intratecal mass, lipoma, or dermal sinus tract indicated the necessity to perform MRI in order to detect spinal cord abnormalities because of higher risk of spinal lesions. CONCLUSION LUS in newborns with specific skin markers is a valid method to select patients in which MRI can be performed to detect OSD. The presence of a simple sacral dimple alone is a negligible marker for occult neural pathology while the presence of isolated dermal sinus or more than one cutaneous marker could be considered indicative of higher risk of spinal dysraphism.
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Affiliation(s)
- E Ausili
- Spina Bifida Center, Women's and Infant Health Sciences, A. Gemelli Policlinic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - G Maresca
- Spina Bifida Center, Women's and Infant Health Sciences, A. Gemelli Policlinic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy
| | - L Massimi
- Neurosurgery Department, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy
| | - L Morgante
- Spina Bifida Center, Women's and Infant Health Sciences, A. Gemelli Policlinic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy
| | - C Romagnoli
- Spina Bifida Center, Women's and Infant Health Sciences, A. Gemelli Policlinic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy
| | - C Rendeli
- Spina Bifida Center, Women's and Infant Health Sciences, A. Gemelli Policlinic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy
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Sonographic spinal imaging of normal anatomy, pathology and magnetic growing rods in children. Pediatr Radiol 2017; 47:1046-1057. [PMID: 28779192 DOI: 10.1007/s00247-017-3845-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/16/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
The wide availability of ultrasound, along with its lack of ionizing radiation burden and need for sedation for most exams, often make sonography the first line in the imaging evaluation of children. The developing osseous anatomy of the spine in young infants provides a distinct window allowing for a detailed depiction of the spinal canal and its contents, which is not present in older children or adults. Here we review the clinical indications, sonographic technique, normal anatomy and pathology for imaging the lumbosacral spine in neonates and young infants. Additionally, we review the procedure for ultrasound assessment of the lengthening of magnetically controlled growing spinal rods, which allows orthopedists and radiologists to evaluate the effectiveness of distraction procedures of this hardware without the use of ionizing radiation.
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Rossi A, Martinetti C, Morana G, Severino M, Tortora D. Diagnostic Approach to Pediatric Spine Disorders. Magn Reson Imaging Clin N Am 2017; 24:621-44. [PMID: 27417404 DOI: 10.1016/j.mric.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.
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Affiliation(s)
- Andrea Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy.
| | - Carola Martinetti
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Giovanni Morana
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Mariasavina Severino
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Domenico Tortora
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
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Alvarado E, Leach J, Caré M, Mangano F, O Hara S. Pediatric Spinal Ultrasound: Neonatal and Intraoperative Applications. Semin Ultrasound CT MR 2017; 38:126-142. [PMID: 28347416 DOI: 10.1053/j.sult.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this article is to review the use of ultrasound as a screening tool for spinal diseases in neonates and infants and its intraoperative value in selected pediatric neurosurgical disorders. A review of spinal embryology followed by a description of common spinal diseases in neonates assessed with ultrasound is presented. Indications for spinal ultrasound in neonates, commonly identified conditions, and the importance of magnetic resonance imaging in selected cases are emphasized. Additionally, the use of ultrasound in selected neurosurgical spinal diseases in pediatric patients is presented with magnetic resonance imaging and intraoperative correlation. Technique, limitations, and pitfalls are discussed.
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Affiliation(s)
- Enrique Alvarado
- Department of Radiology, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH
| | - James Leach
- Department of Radiology, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH.
| | - Marguerite Caré
- Department of Radiology, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH
| | - Francesco Mangano
- Department of Neurosurgery, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH
| | - Sara O Hara
- Department of Radiology, Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH
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Naffaa L, Irani N, Saade C, Sreedher G. Congenital anomalies of lumbosacral spine: A pictorial review. J Med Imaging Radiat Oncol 2016; 61:216-224. [PMID: 27469617 DOI: 10.1111/1754-9485.12499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/18/2016] [Indexed: 11/28/2022]
Abstract
Congenital malformations of the lumbosacral spine include spinal dysraphism and caudal anomalies. Most often, these malformations are discovered prenatally or in early infancy, but some are not diagnosed until late childhood or adulthood. The purpose of this pictorial review is to illustrate the multi-modality imaging characteristics in these complex anomalies and to provide a systematic radiological approach aiming at improving diagnostic accuracy.
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Affiliation(s)
- Lena Naffaa
- Department of Radiology, American University of Beirut, Beirut, Lebanon
| | - Neville Irani
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Charbel Saade
- Department of Radiology, American University of Beirut, Beirut, Lebanon
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