Albakheet Salman S, Yoon Haesung, Lee Mi-Jung, Kim Myung-Joon, Park Eun-Kyung, Shim Kyu-Won, Kim Dong-Seok, Eun Ho Sun, Han Kyunghwa, Shin Hyun Joo
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, King Faisal General Hospital, Al-Hofuf, Saudi Arabia.
Ultrasonography. 2020 Oct;39(4):367-375. doi: 10.14366/usg.19061. Epub 2020 Mar 17.
The purpose of this study was to identify the optimal timing for screening spinal cord ultrasonography (US) to detect filum terminale lipoma in infants.
We retrospectively reviewed infants (<12 months old) who underwent repeated spinal cord US between April 2011 and January 2019. We excluded infants if they only had one US examination, or if they had lesions other than filum terminale lipoma. Infants with filum terminale lipoma on magnetic resonance imaging were included in the lipoma group and the others in the control group. A linear mixed model was used to assess differences in the growth pattern of filum terminale thickness by age and group. The cutoff thickness on US and its diagnostic performance were assessed according to age.
Among 442 infants with 901 US examinations, 46 were included in the lipoma group and 58 in the control group. Sixty-seven infants had unmeasurable filum terminale thickness on initial US, including 55 neonates (82.1%) before 1 month of age. The lipoma group had significantly greater filum terminale thickness than the control group (P<0.001). Thickness increased with age in the lipoma group (P=0.027). The sensitivity of US was 87.5% and the area under the receiver operating characteristic curve was 0.949 (95% confidence interval, 0.849 to 0.991) with a cutoff value of 1.1 mm in 4- to 6-month-old infants.
Screening spinal cord US could effectively diagnose filum terminale lipoma in 4- to 6-month-old infants with a cutoff thickness of 1.1 mm. Spinal cord US can be used to screen young infants with intraspinal abnormalities.
本研究旨在确定筛查脊髓超声（US）以检测婴儿终丝脂肪瘤的最佳时机。
我们回顾性分析了2011年4月至2019年1月期间接受重复脊髓超声检查的婴儿（<12个月）。如果婴儿仅接受过一次超声检查，或患有除终丝脂肪瘤以外的病变，则将其排除。磁共振成像显示有终丝脂肪瘤的婴儿纳入脂肪瘤组，其他婴儿纳入对照组。采用线性混合模型评估终丝厚度随年龄和组别的生长模式差异。根据年龄评估超声的临界厚度及其诊断性能。
在442例接受901次超声检查的婴儿中，46例纳入脂肪瘤组，58例纳入对照组。67例婴儿初次超声检查时终丝厚度无法测量，其中包括55例1月龄前的新生儿（82.1%）。脂肪瘤组的终丝厚度显著大于对照组（P<0.001）。脂肪瘤组的厚度随年龄增加（P=0.027）。在4至6个月大的婴儿中，超声的敏感性为87.5%，受试者操作特征曲线下面积为0.949（95%置信区间，0.849至0.991），临界值为1.1mm。
筛查脊髓超声可有效诊断4至6个月大、临界厚度为1.1mm的婴儿终丝脂肪瘤。脊髓超声可用于筛查有椎管内异常的幼儿。
