SPECTRUM OF FINDINGS OF SPINAL DYSRAPHISM ON MRI

they are limited in use because of their invasive nature and recognized risks. Myelography and post- myelography computed tomography are recommended for those cases in which MRI is equivocal or incomplete. Ultrasonography is primarily useful in the antenatal diagnosis of spinal dysraphism and is used as screening modality in the neonate and infant.There are substantial limitations in B-mode sonography such as imprecise soft tissue characterization, direct contact scanning cannot be performed on patients with exposed neural tissue or fragile meningeal sacs without incurring substantial risk and sonographic penetration of dense scar is poor. Ultrasound becomes progressively less useful as ossication of the posterior elements proceeds during the rst year of life. Magnetic resonance imaging (MRI) is a non invasive technique and has made the diagnosis of spinal dysraphism easier, faster and more accurate, thereby enhancing the possibility of an early and case- tailored treatment, mainly by its multiplanar imaging and tissue characterization capabilities. This procedure can provide a denitive diagnosis without the hazards of ionizing radiation or intrathecal injection of contrast media. ABSTRACT Introduction: Spinal dysraphism or spina bida is a congenital anomaly which includes a heterogeneous group of anomalies resulting from incomplete midline closure of osseous, mesenchymal and nervous tissue.These conditions are usually diagnosed prenatally, at birth, or in early infancy; however, some may be discovered in older children or adults. The incidence of neural tube defects ranges between 1.0 and 10.0 per 1,000 births worldwide, with almost half of these cases falling under the category of spinal dysraphism and the other half consisting of anencephaly cases. The prevalence of neural tube defects (including anencephaly and spinal dysraphism) has been on the decline during the last 25 years as a result of folic acid supplementation. Although plain radiographs, Ultrasonography (primarily in antenatal detection), Myelography, and post-myelography computed tomography are helpful in the diagnosis of spinal abnormalities, Magnetic resonance imaging (MRI) has made the diagnosis of spinal dysraphism easier, faster, and more accurate, thereby enhancing the possibility of early and case-tailored treatment, mainly by its multiplanar imaging and tissue characterization capabilities. Aims and objectives : 1.To assess the role of magnetic resonance imaging (MRI) in the evaluation of the spine and spinal cord malformations. 2. To study the MRI characteristics of the spine and spinal cord malformations. Material and Methods: Patients who were suspected to have spinal malformations on the clinical background were subjected to MRI examination on 1.5 Tesla superconducting magnet, GE Medical systems, using Phased array spine coils. The ndings of MRI spine were assessed and analysed. Results: In the present study out of 30 patients ,spinal dysraphism was most commonly seen in females, with female accounting for 21 cases and males accounting for 9 cases with female to male ratio of 2.3:1.Most cases of spinal dysraphism were seen in 1st decade of life [21 cases , 70%] rd followed by 2nd decade[7 cases , 23%] and rest of the 2 cases(7%) are seen in the 3 decade.In the present study of 30 cases, 21 cases were closed dysraphisms accounting for 70% of total cases, whereas 9 cases were open type accounting for 30% of total cases.In open spinal dysraphism, meningomyeloceles are the most common ones [8 cases, 88.8%] followed by hemimeningomyelocele [1 case,11.1%]. Out of 22 cases of closed spinal dysraphism, diastematomyelia was the most common abnormality present in 8 cases] followed by spinal lipomas [7 cases,25.9%] Conclusion: Basic knowledge of embryogenesis of the spine and spinal cord is essential to understand the wide spectrum of abnormalities seen in spinal dysraphism. A rational approach focusing on a correlation among clinical, embryological, and neuroradiological data greatly facilitates the diagnosis and MRI is the single best safe modality for complete prognostication and for surgical planning.