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Magnetic resonance imaging in children suffering from spina bifida
D Vogl1, E Ring-Mrozik, P Baierl
1Pediatric Surgical Clinic, University Children's Hospital of Munich, Dr. von Haunersches Kinderspital, Germany.
Insights
Magnetic resonance imaging (MRI) is crucial for diagnosing tethered cords in children with myelomeningocele (MMC). Post-surgery, MRI detects residual tethering in most cases, guiding follow-up care.
Area of Science:
- Pediatric Neurosurgery
- Medical Imaging
- Spinal Malformations
Background:
- Myelomeningocele (MMC) is a complex congenital condition requiring surgical intervention.
- Accurate diagnosis and monitoring are essential for managing MMC-related complications.
- Magnetic resonance imaging (MRI) offers detailed visualization of spinal anatomy.
Observation:
- 22 pediatric patients with myelomeningocele (MMC) underwent MRI examinations.
- Tethered spinal cord was identified in 78% of patients post-operatively.
- Untreated lipomyelomeningocele cases showed primary tethered cords in all instances.
Findings:
- MRI revealed associated malformations such as hydromyelia and diastematomyelia.
- No significant correlation was observed between the severity of morphological changes and clinical outcomes.
- Pre-operative MRI is the preferred diagnostic tool for covered MMC.
Implications:
- Post-operative MRI at three months is recommended for MMC patients.
- If initial MRI is clear, biannual ultrasound follow-ups are suggested.
- This imaging protocol aids in timely detection and management of spinal cord complications in pediatric MMC.
Abstract:
22 children with myelomeningocele (MMC) were examined by magnetic resonance imaging (MRI). After operative closure a tethered cord was found in 78% of the patients. A primary tethered cord was detected in all patients where a lipomyelomeningocele had not been operated on yet. Additional malformations shown by MRI were hydromyelia and diastematomyelia. No correlation could be found between the degree of morphologic changes and the clinical course. In covered MMCs, MRI investigation is recommended as method of choice before operation. After operative closure a control-MRI should be performed after three months. If there are no pathological findings, further follow-up should be done by ultrasound investigation twice a year.