Role of different MRI sequences in evaluation of pediatric spinal dysraphism

Abstract

ObjectiveThe aim was to assess type and extent of clinically evident or suspected spinal abnormalities by MRI and to compare different sequences for identifying nervous and fatty tissue in different abnormalities.BackgroundSpinal dysraphisms are congenital abnormalities of spine and spinal cord owing to faulty closure of midline structures. Imaging of spinal dysraphism should follow an organized approach and correlation between radiological, clinical, and developmental data should help in appropriate diagnosis. MRI is considered the best imaging modality for these abnormalities.Materials and MethodsPediatric patients aged 1 day till 2 years old, clinically evident or suspected to have spinal dysraphism, having back swelling, skin pigmentations, skin tags, hair tufts, hemangiomas of the back, criteria were included and underwent MR scan in Toshiba Excelart Vantage Titan (Japan) 1.5 Tesla MR Set with standard 16-channel head coil.ResultsOf 43 pediatric patients dated since birth till 2 years old with clinical evidence or suspicion of congenital spinal abnormalities for MRI scanning, spina bifida (41.9%), bony deformities (30.2%), tethered cord (27.9%), meningomyelocele (25.6%) were the commonest congenital spinal abnormalities. Neural tissues in the herniated thecal sac were detected in combination of three-dimentional half Fourier-acquired single-shot turbo spin echo (3D HASTE) sequence with turbo spin echo T1-weighted (TSE T1W) sequence in 15 patients, which was significantly high as compared with combinations of TSE T1W sequence with TSE T2 weighted (T2W), with short-time inversion recovery (STIR) and with single-shot myelographic sequence probability value of 0.03, 0.02, and 0.01, respectively. Fatty tissue was found in four cases, which were detected by a combination of STIR and TSE T1W sequences in all four patients.ConclusionPediatric spinal dysraphism and different spinal anomalies can be diagnosed by MRI scanning with excellent accuracy. STIR and 3D-HASTE sequences should be part of the examination protocol of spinal dysraphism.