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Normal fetal sacrum simulating spina bifida: "pseudodysraphism".

M A Dennis, J A Drose, D H Pretorius

    Radiology
    |June 1, 1985
    PubMed
    Summary
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    Obstetric ultrasound (US) can misdiagnose spina bifida due to unfamiliarity with normal fetal anatomy or artifacts. Caution is advised when diagnosing lumbosacral spina bifida without a visible sac or mass, especially with transducer angulation.

    Area of Science:

    • Medical imaging
    • Fetal medicine
    • Radiology

    Background:

    • Accurate diagnosis of fetal spinal abnormalities is crucial in prenatal care.
    • Obstetric ultrasound (US) is a primary tool for evaluating fetal anatomy.
    • Understanding normal and abnormal findings is essential for correct interpretation.

    Observation:

    • Two neonates were initially diagnosed with sacral dysraphism in utero via US.
    • These cases were compared with US and CT scans of a normal fetal cadaver specimen.
    • The apparent abnormalities were linked to examiner unfamiliarity with normal sacral anatomy and US artifacts.

    Findings:

    • Erroneous diagnoses of spina bifida can occur with obstetric ultrasound.
    • Lack of familiarity with normal fetal sacral anatomy can lead to misinterpretation.

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  • Image artifacts can mimic spinal defects, particularly with transducer angulation.

    • Implications:

    • Emphasizes the need for thorough training in fetal spinal anatomy for sonographers.
    • Highlights the importance of recognizing US artifacts to prevent false positives.
    • Recommends cautious diagnosis of lumbosacral spina bifida, especially when no sac or mass is visualized.