Evaluation of spinal ultrasound in spinal dysraphism.
OBJECTIVE
The aims of this study were to evaluate the role of spinal ultrasound in detecting occult spinal dysraphism (OSD) in neonates and infants, and to determine the degree of agreement between ultrasound and magnetic resonance imaging (MRI) findings.


METHODS
Eighty-five consecutive infants had spinal ultrasound over 31 months. Of these, 15 patients (age 1 day-7 months, mean 40 days; nine male) had follow-up MRI. Ultrasound and MRI findings were correlated retrospectively.


RESULTS
Six out of 15 (40%) ultrasound examinations showed full agreement with MRI, seven of 15 (47%) had partial agreement, and two of 15 (13%) had no agreement. In the present series ultrasound failed to visualize: four of four dorsal dermal sinuses, three of four fatty filum terminales, one of one terminal lipoma, two of four partial sacral agenesis, three of four hydromyelia and one of 10 low-lying cords.


CONCLUSIONS
Agreement between ultrasound and MRI was good, particularly for the detection of low-lying cord (90%). Therefore we recommend ultrasound as a first-line screening test for OSD. If ultrasound is abnormal, equivocal or technically limited, MRI is advised for full assessment.
Hughes
J A
JA
Great Ormond Street Hospital for Children, London, UK. jaqhughes@hotmail.com
De Bruyn
R
R
Patel
K
K
Thompson
D
D
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000592:standards; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging*; D014463:Ultrasonography