Spinal ultrasound in cloacal exstrophy.
OBJECTIVE
To assess the diagnostic value of spinal ultrasound in cloacal exstrophy, a caudal malformation which is associated with spinal dysraphism, and to assess the prevalence of spinal dysraphism in cloacal exstrophy.


METHODS
Ten infants under 1 year old with cloacal exstrophy underwent spinal ultrasound at presentation. Three patients also had a magnetic resonance imaging (MRI) examination. Ultrasound and MRI images were reviewed and correlated.


RESULTS
Nine of 10 patients had no external signs of spinal dysraphism. One patient had a clinically apparent myelomeningocele. Five of 10 patients (50%) had spinal dysraphism on ultrasound: there were two patients with a low cord, two with tethered cords and a lipoma, and one patient with tethering and a myelomeningocele. Thus, in four of these five patients spinal dysraphism was occult. In a small number of patients (n = 3) MRI was also performed-in these cases the MRI and ultrasound appearances correlated, however MRI was not performed in those patients in whom spinal ultrasound was normal.


CONCLUSIONS
In three cases where spinal ultrasound detected occult dysraphism and MRI was performed, spinal ultrasound and MRI correlated. Advantages of spinal ultrasound include ease of examination, production of high quality multi-planar images and the facility for portable imaging at the bedside. Spinal ultrasound should be the first investigation in all babies with cloacal exstrophy to diagnose occult and non-occult spinal dysraphism.
Dick
E A
EA
Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
de Bruyn
R
R
Patel
K
K
Owens
C M
CM
D002988:Cloaca / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007412:Intestinal Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D008591:Meningomyelocele / Q000000981:diagnostic imaging / Q000209:etiology; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography