Background
Spinal dysraphism includes wide range of pathologies occurring due to aberrations in development of spinal cord.
Spinal cord development includes three phases namely gastrulation,
primary neurulation and secondary neurulation.
Gastrulation involves conversion of the bilaminar embryonic disk to a trilaminar disk composed of ectoderm,
mesoderm,
and endoderm.
Another critical event occurring along with gastrulation is the formation of notochord,
cylindrical structure of mesodermal origin.
Primary neurulation involves closure of neural plates to form neural tube.
Notochord invites the ectodermal cells to differentiate into neural precursor...
Findings and procedure details
In MR imaging of spine,
different techniques are used depending upon the clinical situation.
For spinal dysraphisms ,
we acquire both T1W and T2Waxial and sagittal images.
T1WIdemonstrate spinal cord without associated artifacts from circulating CSF.
T2-weighted images show cauda equina,filum terminale,
adhesions and any bony or fibrous spurs.
These sequences can be performed with and without fat saturation,
as in selected cases fat suppression is helpful for assessment of intra-spinal fatty lesions.
Important concept to remember is that a single patient may have multiple...
Conclusion
Knowledge of normal development of spine and spinal cord provides framework for understanding spinal dysraphismsthat are complex and variable in imaging appearance.
Accurate and early diagnosis of spinal dysraphisms is essential for optimal,
individualized neurosurgical treatment.
An organized approach to imaging findings with consideration of clinical and developmental factors allows greater ease in diagnosis.
Personal information
Personal information
Contact details:
Dr.
Suriyaprakash Nagarajan
Junior Resident,
Department of Radiology,
Govt Royapettah Hospital,
Govt Kilpauk Medical College,
Chennai,
Tamil Nadu,
India.
Email:
[email protected]
Dr.
K.
Gopinathan
Professor of Radiology,
Govt Royapettah Hospital,
Govt Kilpauk Medical College,
Chennai,
Tamil Nadu,
India.
Email:
[email protected]
Dr.
J.
Devimeenal
Professor & HOD of Radiology,
Govt Kilpauk Medical College,
Chennai,
Tamil Nadu,
India.
Email:
[email protected]
Dr.P.
Chirtrarasan
Professor of Radiology,
Govt Kilpauk Medical College,
Chennai,
Tamil Nadu,
India.
Email:
[email protected]
References
References:
James Barkovich & Charles Raybaud – Pediatric neuroimaging 5thedition
Diagnostic Radiology - Pediatric Imaging 3rd edition
Chad J.
Jensen- Brief History of Occult Spinal Dysraphism - The Spine Scholar - Volume 1,
Number 2,
2017
Stephanie L.
Rufener,
Mohannad Ibrahim,
Charles A.
Raybaud,
Hemant A.
Parmar - Congenital Spine and Spinal Cord Malformations—Pictorial Review-AJR:194,
March 2010
Jyoti Kumar,
Muhammed Afsal,
and Anju Garg - Imaging spectrum of spinal dysraphism on magnetic resonance: A pictorial review - World J Radiol.
2017 Apr 28; 9(4): 178–190....