Role of magnetic resonance imaging (MRI)‎ in diagnosis of spinal congenital anomalies

Abstract EN

Background / Am : the tissue MR contrasts are relatively large : cord substance, cerebrospinal fluid, fat and bone.

The strength of the signal from the spine is usually better on sagittal and coronal than on axial images.

Spin echo sequences are preferred.

Short echo times result in strong signals and a good anatomical display.

Longer echo times result in reduced signal strength and increased sensitivity for detection of pathological processes in the spine.

The aim of the present study was to evaluate the role of MRI in the diagnosis of congenital lesions occurring in the spine and the spinal cord regarding detection, accurate localization and if possible associations.

Patients & Methods : this study included 32 patients, 18 females and 14 males.

Their ages ranged from one day to 34 ears.

All cases were subjected to full clinical assessment and magnetic resonance imaging (MRI).

Computed tomography was done for 2 cases and plain X-ray done for 6 patients.

Results : the patients were presented with symptoms and signs which suggest underlying spinal cord anomalies i.e.

back masses either non-skin covered in 18 patients (56.25 %) or skin covered back masses in 8 patients (25 %), urine incontinence in 10 patients (31.25 %), motor deficit in 13 patients (40.6 %), sensory deficit in 6 patients (18.7 %) and back pain in two patients (6.2 %).

Cutaneous manifestations including hypertrichosis, cutaneous haemangioma, skin lags and dermal pits were detected in 12 patients (37.5 %) and operative scars detected in four patients (12.5 %).

Other associated anomalies included congenital tulips equinovarus in 13 patients (62.5 %), high arched foot in 6 patients (18.7%), and limb length discrepancy in one patient (3.1 %) and congenital hip dislocation in one patient (3.1 %).

Non- skin covered back masses were diagnosed in 18 patients ; myelomeningocele in 15 patients and myeloschisis in 3 patients.

Skin- covered back masses were diagnosed in 8 patients ; meningeal in 4 patients, lipo myelomeningocele in 2 patients, lip omen lose his is in one patient and myelocystocele in one patient.

Occult spinal dysraphism was diagnosed in 6 patients; 2 patients with caudal regression syndrome, one patient with diastematomyelia, one patient with dermal sinus, one patient with intrasacral meningeal and one patient with spinal lipoma.

Conclusion : Finally we conclude that, MRI is a safe, simple, easy and non-invasive technique for detection of detailed anatomy and characterization of congenital spinal disorders.