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Fetal imaging approach to spinal dysraphism diagnosis
Usha D Nagaraj1,2, Karin S Bierbrauer3,4, Beth M Kline-Fath3,4
1Clinical Radiology Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA. usha.nagaraj@cchmc.org.
Pediatric Radiology
|June 20, 2025
Summary
Prenatal spinal dysraphism, a condition affecting fetal spine development, is commonly diagnosed using fetal magnetic resonance imaging (MRI). This review focuses on MRI findings for classifying spinal defects to guide prenatal care and management.
Area of Science:
- Radiology and Imaging
- Fetal Medicine
- Pediatric Surgery
Background:
- Prenatal spinal dysraphism is a frequent indication for fetal magnetic resonance imaging (MRI).
- Fetal MRI is crucial for diagnosis confirmation, classification, and identifying imaging features that inform prenatal counseling and perinatal management.
- Spinal dysraphic defects are categorized as open (not skin-covered) or closed (skin-covered).
Purpose of the Study:
- To present a systematic approach for classifying fetal spinal dysraphism based on MRI findings.
- To review common types of fetal spinal dysraphism encountered in clinical practice.
- To highlight the role of MRI in guiding prenatal surgical decisions and management strategies.
Main Methods:
- Review of fetal MRI imaging findings in cases of prenatal spinal dysraphism.
- Classification of spinal dysraphic defects based on imaging characteristics, particularly the presence or absence of a sac.
- Discussion of common spinal dysraphism entities diagnosed prenatally.
Main Results:
- Open spinal dysraphic defects are potential candidates for prenatal surgery.
- Closed spinal dysraphic defects are classified by the presence or absence of a sac on fetal imaging.
- Closed spinal dysraphism without a sac on fetal imaging is often complex, while simple forms are less frequently diagnosed prenatally.
Conclusions:
- Fetal MRI is instrumental in diagnosing, classifying, and managing prenatal spinal dysraphism.
- MRI findings aid in differentiating between open and closed defects, influencing treatment planning.
- A structured approach to MRI interpretation is essential for accurate classification and optimal patient care.
