Spinal imaging features in Japanese patients with Marfan syndrome: a case-control study.
OBJECTIVE
The purpose of our study was to evaluate the morphology of the lumbosacral spine, i.e. the dura and vertebral body shape, of Japanese patients with Marfan syndrome (MFS) by comparing it with sex- and age-matched controls.


METHODS
Spinal MR or CT images of 32 MFS patients and 32 controls were retrospectively reviewed. The anteroposterior dural sac diameter (DSD), anteroposterior vertebral body diameter (VBD), and vertebral body height (VBH) were measured from L1 to S1 levels and the dural sac ratio [DSR = (DSD/VBD)] and vertebral body aspect ratio [VAR = (VBH/VBD)] were calculated.


RESULTS
At each level, mean DSD and DSR were significantly higher in MFS patients; VBD was not. The cutoff values for DSR to differentiate between MFS patients and the controls were 0.59, 0.46, 0.42, 0.45, 0.47, and 0.47 from the level of L1 to S1. At a sensitivity of 93.8 % and a specificity of 84.4 % the cutoff value at S1 was most diagnostic. In MFS patients VAR was significantly higher at L3 and L4.


CONCLUSIONS
Our cutoff value for DSR >0.47 at S1 may help to identify MFS in the Japanese population. A square-like appearance of the L3 and L4 vertebral bodies is a supplementary finding in MFS patients.
Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto-shi, Kumamoto, 861-4193, Japan.
Eri
E
Hayashida
Daisuke
D
Utsunomiya
Akira
A
Sasao
Tsuyoshi
T
Yasuda
Toshinori
T
Hirai
Hideaki
H
Yuki
Seitaro
S
Oda
Joji
J
Urata
Akihiko
A
Arakawa
Yasuyuki
Y
Yamashita
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007564:Japan; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008382:Marfan Syndrome / Q000175:diagnosis*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult