Ultrasound and magnetic resonance imaging in the prenatal diagnosis of open spina bifida

Abstract

Open spina bifida, also known as spina bifida aperta is a neural tube defect involving the lack of closure of vertebral arches and associated meninges and/or spinal cord abnormalities.Ultrasound examination is the gold standard for the diagnosis of spina bifida aperta. It represents the main imaging tool used to ascertain this diagnosis early in gestation. Three-dimensional ultrasound is necessary to detect the level and the size of the defect. Magnetic resonance imaging (MRI) represents a more sensitive tool, giving specific information of the defect and associated anomalies, playing an important role in ruling out differential diagnosis. Due to the advent of MRI use, it is possible today to achieve in utero treatment of fetuses with this pathology. The aim of the current review is to provide an update of literature regarding the role of ultrasound and MRI in the prenatal diagnosis of spina bifida aperta.

Diagnostic value of spinal ultrasound compared to MRI for diagnosis of spinal anomalies in pediatrics

“…Spinal dysraphism includes a spectrum of congenital disorders and it is caused by imperfect fusion of midline bony, mesenchymal and neural structures due to incomplete closure of the neural tube in early embryoneogenesis [1]. Spinal dysraphism is divided into two broad groups: spina bifida aperta (posterior protrusion of neural tissue through a bony vertebral defect with exposure of neural tissue, not covered by skin); and spina bifida occulta with and without a skin-covered back mass [2].…”

Fetal magnetic resonance imaging in the diagnosis of spinal cord neural tube defects: A prospective study

“…LOGIQ 9 and Voluson E8 ultrasonic devices manufactured by GE of the USA were used for scanning at 3.5–5.0 Hz ( 6 , 11 ). By observing the lamina closure of the fetus, position and shape of the conus spinal cord, shape of the spinal canal, and relationship between the end of the conus spinal cord and spinal canal, the fetal spinal neural tube malformation was determined.…”

“…It has the following advantages: it is economical and safe and involves dynamic observation. However, the spatial and tissue resolutions of ultrasound examination are relatively low, and the imaging quality is poor when factors such as significantly low amniotic fluid, maternal obesity, fetal malposition, late pregnancy, abdominal scar of pregnant women, and fetal bone occlusion exist ( 6 , 7 ).…”

Madelung Disease – Between Lipectomy and Liposuction. Report of a Case and Literature Review

“…Although rarely, the condition is also described in pediatric ages, when diagnostic imaging is of utmost importance, in order to differentiate this disorder from other congenital diseases. (17) A list of possible differential diagnoses should include: morbid obesity, Cushing's syndrome, salivary gland pathologies, lymphoma, Froelich's syndrome, angiolipomatosis, mixed-type liposarcoma, neurofibromatosis or Dercum's disease. (16,18) Medical treatment strategy uses fibrate therapy, which is considered to reduce further progression of the disease by lowering triglycerides concentrations in blood serum.…”