Optimal Filum Terminale Thickness Cutoff Value on Sonography for Lipoma Screening in Young Children

Area of Science:

• Pediatric Radiology
• Neuroimaging
• Ultrasound Diagnostics

Background:

• The filum terminale is a crucial anatomical structure in the lower spinal cord.
• Accurate assessment of filum terminale thickness is vital for diagnosing conditions like lipomas.
• Current sonographic cutoff values for filum terminale thickening may lack precision in young children.

Purpose of the Study:

• To establish normal sonographic measurements of the filum terminale in infants and young children.
• To determine an optimal, more sensitive cutoff value for screening filum terminale lipomas.
• To improve diagnostic accuracy in pediatric spinal imaging.

Main Methods:

• Retrospective analysis of lumbosacral sonograms and MRI in children under 36 months.
• Evaluation of filum terminale thickness on ultrasound and fat infiltration on MRI.
• Comparison of measurements between normal and lipoma groups, including multivariable and propensity score analyses.

Main Results:

• Filum terminale thickness was significantly greater in children with lipomas (1.5 ± 0.5 mm) compared to controls (0.9 ± 0.2 mm).
• Filum terminale thickness demonstrated statistical significance in multivariable and propensity score analyses.
• An optimal cutoff value of 1.1 mm was identified for filum terminale lipoma screening, offering 94% sensitivity and 86% specificity.

Conclusions:

• The traditional 2 mm cutoff for filum terminale thickening on sonography is likely too high for effective screening in young children.
• A revised cutoff of 1.1 mm is recommended for improved sonographic screening of filum terminale lipomas in this age group.
• This finding can enhance early detection and management of spinal lipomas in pediatric patients.