Learning objectives
To review the indications for a spinal ultrasound study in newborns.
To review and illustrate the normal anatomy,
normal variants and pathologic conditions of the spine in newborns,
focusing on the ultrasound imaging features.
Background
Ultrasonography is a valid method in the evaluation of the neonatal spine,
in appropriate clinical setting.
Since the ossification of the spinal posterior elements occurs months later,
the spinal canal content may be readily accessed through ultrasonography.
A range of normal findings,
including normal variants,
and pathologic conditions may be accurately demonstrated.
The major goal of a spinal ultrasound study in newborns is to exclude occult spinal dysraphism.
Spinal dysraphism represents a heterogeneous group of congenital abnormalities of the spine and spinal cord,
resulting from...
Findings and procedure details
Indications for a spinal ultrasound study in newborns
All the conditions that may be associated with closed spinal dysraphism are indications for performing a spinal ultrasound study as a screening tool in newborns.
They include[1,3]:
- Midline cutaneous stigmata of the back (sacral dimple,
particularly if located further than 2,5 cm from the anus; hemangiomatous lesion; hairy patches; skin tags);
- Soft-tissue mass of the back;
- Congenital abnormalities:
Genitourinary malformations
Anorectal malformations
Sacral abnormalities.
Specifically at our institution,
these exams are only performed in...
Conclusion
Together with complete clinical assessment,
ultrasound is a reliable method to evaluate the spine in newborns,
and can be used as the initial imaging modality to rule out significant pathologic conditions affecting spinal cord and/or spinal canal.
The radiologist should be familiar with normal anatomy,
variants that may simulate disease and pathologic conditions,
in order to make an accurate diagnosis and,
thus,
prevent unnecessary examinations or prioritize the required MRI studies/surgical interventions.
Personal information
Ana Rita Ventosa1
Henrique Patrício1
1.Department of Radiology
Centro Hospitalar e Universitário do Algarve
Portugal
References
1.
Dick EA,
Patel K,
Owens CM,
Bruyn R.
Spinal ultrasound in infants.
The British Journal of Radiology 2002; 75: 384-392.
2.Rufener SL,
Ibrahim M,
Raybaud CA,
Parmar HA.
Congenital spine and spinal cord malformations - pictorial review.
AJR 2010; 194: S26–S37.
3.
Lowe LH,
Johanek AJ,
Moore CH.
Sonography of the neonatal spine: part 1,
normal anatomy,
imaging pitfalls,
and variations that may simulate disorders.
AJR 2007; 188: 733-738.
4.
Lowe LH,
Johanek AJ,
Moore CH.
Sonography of the neonatal spine: part 2,
spinal...