University of Missouri School of Medicine, Columbia, Missouri.
Department of Radiology, University of Missouri Hospital, Columbia, Missouri.
Am J Perinatol. 2024 May;41(S 01):e1156-e1162. doi: 10.1055/a-2000-6232. Epub 2022 Dec 17.
Ultrasound (US) is a common imaging modality used to evaluate spinal anomalies in newborns. However, many indications for the use of spinal US are associated with low diagnostic yield. The purpose of this study is to evaluate the indications and the diagnostic utility of spinal USs performed in newborns at our institution. We also review patient presentations for caudal regression syndrome (CRS) that was identified from the USs performed.
This study is a retrospective review of spinal USs performed between January 1, 2006, and December 31, 2021, in newborns at a single institution. Indications for each US and any associated abnormalities were noted. Infants with abnormal USs showing CRS are described with their long-term medical outcomes.
A total of 592 USs were performed during the specified time period of which 72 (12%) were abnormal. The presence of a sacral dimple was the most common indication for performing a spinal US, although only 14 (4%) were identified as abnormal. Of these 14, 6 (43%) were further evaluated by spinal magnetic resonance imaging (MRI) at the recommendations of a pediatric radiologist and of these, only 2 (14%) had abnormal MRI findings. The two newborns with abnormal MRI findings had mothers with diabetes mellitus in their pregnancies. Of note, one additional newborn had abnormalities on spinal US that was never confirmed on MRI due to being lost to follow-up. Among the other indications, anorectal anomalies (odds ratio [OR], 7.55; 95% confidence interval [CI], 3.01-18.91), spinal mass (OR, 17.99; 95% CI, 7.86-41.2), and meningocele were most associated with abnormal findings.
Overall, spinal US has a low diagnostic yield. Sacral dimple was the most common indication for performing a spinal US but had a low yield with few long-term sequelae. Anorectal anomalies had a strong association with abnormal US findings.
· Sacral dimple is a common indication for spinal ultrasound.. · Spinal ultrasound has low diagnostic yield when performed for sacral dimple.. · Caudal regression syndrome is associated with maternal diabetes and numerous long-term comorbidities..
超声（US）是一种常用于评估新生儿脊柱异常的常用成像方式。然而，许多使用脊柱 US 的指征与较低的诊断收益相关。本研究的目的是评估我院新生儿进行脊柱 US 的指征和诊断效用。我们还回顾了从进行的 US 中发现的尾骨退化综合征（CRS）的患者表现。
这是对 2006 年 1 月 1 日至 2021 年 12 月 31 日期间在一家机构进行的新生儿脊柱 US 的回顾性研究。注意到每个 US 的指征和任何相关异常。描述了具有异常 US 显示 CRS 的婴儿及其长期医疗结局。
在指定期间共进行了 592 次 US，其中 72 次（12%）异常。存在骶尾部凹陷是进行脊柱 US 的最常见指征，尽管只有 14 次（4%）被确定为异常。在这 14 例中，根据儿科放射科医生的建议，有 6 例（43%）进一步进行了脊柱磁共振成像（MRI）检查，其中只有 2 例（14%）MRI 检查结果异常。这两名患有异常 MRI 发现的新生儿的母亲在怀孕期间患有糖尿病。值得注意的是，还有 1 名新生儿的脊柱 US 异常，但由于失访从未在 MRI 上得到证实。在其他指征中，肛门直肠畸形（比值比 [OR]，7.55；95%置信区间 [CI]，3.01-18.91）、脊柱肿块（OR，17.99；95% CI，7.86-41.2）和脑膜膨出与异常发现最相关。
总体而言，脊柱 US 的诊断收益较低。骶尾部凹陷是进行脊柱 US 的最常见指征，但收益较低，很少有长期后遗症。肛门直肠畸形与异常 US 发现有很强的关联。
·骶尾部凹陷是脊柱超声的常见指征。·当因骶尾部凹陷进行脊柱超声检查时，其诊断收益较低。·尾骨退化综合征与母体糖尿病和多种长期合并症相关。
