Prenatal diagnosis of diastematomyelia: presentation of eight cases and review of the literature

Has, Recep; Yüksel, Atıl; Büyükkurt, Selim; Kalelioğlu, I.; Tatlı, Burak

doi:10.1002/uog.4066

Cited by 40 publications

(31 citation statements)

References 12 publications

(12 reference statements)

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“…The sagittal cleft may involve the spinal cord, conus medullaris or filum terminale. When there are no other associated spinal anomalies, the prognosis is favorable, with normal α-fetoprotein and amniotic fluid acetylcholinesterase levels [8]. …”

Section: Classification Of Spinal Defectsmentioning

confidence: 99%

The Diagnostic Features of Spina Bifida: The Role of Ultrasound

Coleman

Langer

Horii³

2014

Fetal Diagn Ther

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Myelomeningocele (MMC) is one of the most devastating, nonlethal congenital anomalies worldwide. The live birth prevalence of MMC changed dramatically in the 1980s with the introduction of maternal serum screening and the widespread use of prenatal ultrasound imaging. The high-resolution ultrasound affordable today with state-of-the-art equipment allows us to make a very accurate diagnosis of MMC, including details related to the entire fetal central nervous system. Ultrasound can accurately localize the site of the osseous and soft tissue defects. Congenital spinal defects can be characterized definitively as open or closed, which are treated very differently with in utero repair, which is done in some cases, compared to only conservative follow-up with postnatal therapy for occult defects. Additional findings of kyphosis, scoliosis and anomalous vertebrate and associated conditions such as cervical syrinx can be identified. The state of the intracranial structures, including the presence or absence of ventriculomegaly and hindbrain herniation, as well as unexpected complications such as intracranial hemorrhage can be diagnosed. The severity of neurological compromise in some fetuses can be estimated by detailed examination of the lower extremities. As well as searching for talipes, we also now routinely characterize flexion and extension motions at the hip, knee and ankle joints. The information provided by ultrasound plays a crucial role, now more than ever, in patient counseling and pregnancy management. This article emphasizes how we utilize ultrasound in the evaluation of patients with suspected MMC at the Center for Fetal Diagnosis and Treatment at the Children's Hospital of Philadelphia.

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Section: Classification Of Spinal Defectsmentioning

confidence: 99%

The Diagnostic Features of Spina Bifida: The Role of Ultrasound

Coleman

Langer

Horii³

2014

Fetal Diagn Ther

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“…Thus, we changed the initial US diagnosis of type I split cord malformation or spinal cord doubling to type II split cord malformation, which has a considerably more favorable prognosis [2].…”

Section: Case Reportmentioning

confidence: 99%

Fetal diastematomyelia associated with vertebral malformation: ultrasound, MRI, and pathomorphological findings

et al. 2015

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Using a specific clinical example, we demonstrate the ability of prenatal magnetic resonance imaging (MRI) to diagnose associated spine and spinal cord malformations in the group of spinal dysraphisms. Thus, the original ultrasound (US) and MRI results for the affected fetus at week 21 are illustrated and described in detail. The paucity of reports of prenatal MR-semiotic findings of split cord malformation comparing US and pathomorphological findings at a relatively early gestational age makes the present case unique and instructive. The outstanding capability of MRI to diagnose spinal pathologies indicates the necessity of including prenatal MRI in the diagnostic algorithm to determine the severity of the lesions and the appropriate management during pregnancy, childbirth, and the early postnatal period.

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“…Abnormal traction in the spinal canal with a thick FT should prompt careful examination of the sacral vertebrae because of the risk of sacral agenesis. Second is the presence of associated malformations, especially lipomyelocele, lipoma and diastematomyelia [20]. Lipomas of the CM are more underdiagnosed than those of the filum [2,21].…”

Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

et al. 2016

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Background: Sonographic evaluation of the fetal conus medullaris (CM) level is not reproducible. The objectives of this study were to determine the normal position of the fetal CM during pregnancy as well as the normal intradural filum terminale (FT) length and to evaluate their use in detecting tethered cord. Methods: This is a prospective evaluation of normal singleton pregnancies examined by sonography from 17 weeks of gestation to term. Each sonographer had to identify the top of the first sacral vertebra (S1) to measure the distance between it and the conus extremity (CM-S1 distance). The intradural FT distance was measured with 5- to 8-MHz probes. Results: 194 consecutive pregnant women were included. The CM and intradural FT were demonstrated clearly in 164 (84%) cases. The mean CM-S1 distance was 20.6 mm (range 0.5-42). The mean intradural FT distance was 27.9 mm (range 6.6-49.3). Linear regression analysis showed a significant association between both those distances and gestational age (p < 0.05). In cases of tethered cord, the mean CM-S1 distance and the mean intradural FT distance were both below the 5th percentile. Conclusion: Prenatal evaluation of the CM and the intradural FT is feasible and reproducible and seems useful in detecting tethered cord.

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Prenatal diagnosis of diastematomyelia: presentation of eight cases and review of the literature

Abstract: Objectives

Cited by 40 publications

References 12 publications

The Diagnostic Features of Spina Bifida: The Role of Ultrasound

The Diagnostic Features of Spina Bifida: The Role of Ultrasound

Fetal diastematomyelia associated with vertebral malformation: ultrasound, MRI, and pathomorphological findings

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

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