Shear Wave Elastography of Spinal Cord in Children With Meningomyelocele

To assess the spinal cord elasticity values using shear wave elastography (SWE) in children with meningomyelocele (MMC).

In this IRB-approved prospective study, 70 children (< 6 months of age) with MMC were included from July 2022 to June 2024. A total 50 children (< 6 months of age) without any neurological symptoms were enrolled as controls. SWE measurements were recorded in cases and controls in the lower dorsal region (D10-D12 level) in the dura mater, arachnoid mater, pia mater, and central canal. Brain ultrasound was done in all cases to look for hydrocephalus. Correlation of the spinal cord stiffness values was done with neurological deficits and hydrocephalus. The statistical tests were done at a significance level of α = 0.05.

The mean ± SD (median, IQR) elastography (kPa) of controls recorded at the dura mater, arachnoid mater, pia mater, and central canal was 31.56 ± 13.28 (30.30, 24.00-38.00), 24.57 ± 13.47 (23.50, 14.75-34.08), 22.6 ± 12.23 (22.00, 11.60-29.50), and 21.45 ± 10.80 (18.00, 12.60-28.00), respectively, while in cases it was 53.46 ± 31.38 (45.90, 33.00-65.00), 45.17 ± 22.21 (41.85, 31.00-53.75), 39.49 ± 18.76 (37.35, 28.00-48.00), and 36.91 ± 17.62 (34.00, 23.25-44.27), respectively. A statistically significant difference was seen between the elasticity values of the controls and cases (p < 0.001), the values being higher in cases. No significant difference was observed between the elasticity values at different sites in cases with or without neurological deficits. A statistically significant difference was seen between the elasticity values in dura mater, only in the cases with and without hydrocephalus (p < 0.001), the values being higher in cases with hydrocephalus.

Children with MMC had stiffer spinal cords than normal children. The elasticity values of dura mater, arachnoid mater, pia mater, and central canal were higher in cases with hydrocephalus than in those without hydrocephalus.