Fetal imaging approach to spinal dysraphism diagnosis

Prenatal spinal dysraphism is a common reason for referral for fetal magnetic resonance imaging (MRI). Fetal MRI can not only help confirm the diagnosis but also aid in classification and identification of imaging findings that help guide prenatal counseling and perinatal management. Open spinal dysraphic defects, or those that are not skin-covered, are potential candidates for prenatal surgery. Closed, or skin-covered, spinal dysraphic defects occur in many forms and can be classified by the presence or absence of a sac on fetal imaging. Closed spinal dysraphism identified without a sac on fetal imaging is typically complex in nature, with simple forms being less commonly diagnosed in the prenatal period. In this article, we will review a method of approaching the classification of fetal spinal dysraphism with a focus on MRI findings and review examples of some of the most common entities encountered in clinical practice.