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Sonography of the Neonatal Spine: Part 2, Spinal Disorders

¹ Department of Radiology, The University of Missouri-Kansas City, Kansas City, MO.
² Department of Radiology, Children's Mercy Hospital and Clinics, 2401 Gillham Rd., Kansas City, MO 64108.
³ Department of Radiology, St. Luke's Hospital, Kansas City, MO.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Tethered cord in 2-day-old boy with multiple congenital anomalies. Longitudinal sonogram shows low-lying conus (arrowhead) at L5 vertebra and thickened, echogenic fatty filum (arrow).

View larger version (84K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Tethered cord in 2-day-old boy with multiple congenital anomalies. Sagittal T1-weighted MR image confirms thick, fatty filum (arrow) overlapping tethered cord from L4 to S1 level.

View larger version (80K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Syrinx and tethered cord in 1-week-old girl with imperforate anus and scoliosis. Longitudinal sonogram reveals low-lying conus at L4 vertebra with hypoechoic cystic space (arrow) expanding lumbar spinal cord.

View larger version (91K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Syrinx and tethered cord in 1-week-old girl with imperforate anus and scoliosis. Sagittal T2-weighted MR image confirms conus is tethered at S1 level (arrowhead) and lumbar spinal cord contains large, hyperintense, fusiform syrinx (arrow).

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Intradural lipoma and tethered cord in 2-week-old girl with hairy patch on lower back. Longitudinal sonogram reveals typical features of hyperechoic lipoma (calipers) attached to dorsal aspect of thoracolumbar spinal cord. Conus is tethered to mass at L3-L4 disk space (arrow).

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Intradural lipoma and tethered cord in 2-week-old girl with hairy patch on lower back. Transverse sonogram at L3 vertebra shows conus (arrow) tethered to dorsal lipoma (arrowhead).

View larger version (106K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Lipomyelomeningocele in 1-day-old girl with soft-tissue swelling on lower back. Longitudinal (A) and transverse (B) sonograms show lumbosacral dysraphism through which spinal cord (straight arrow), hyperechoic fatty tissue (curved arrow), and hypoechoic CSF (arrowhead, B) pass.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Lipomyelomeningocele in 1-day-old girl with soft-tissue swelling on lower back. Longitudinal (A) and transverse (B) sonograms show lumbosacral dysraphism through which spinal cord (straight arrow), hyperechoic fatty tissue (curved arrow), and hypoechoic CSF (arrowhead, B) pass.

View larger version (95K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —Lipomyelomeningocele in 1-day-old girl with soft-tissue swelling on lower back. T1-weighted sagittal MR image confirms lumbosacral dysraphism with intra- and extradural adipose tissue (arrows), neural tissue (arrowhead), and tethered cord.

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —Fatty filum in 23-week-old boy with sacral dimple who is otherwise developmentally normal. Longitudinal sonogram shows focus of segmental increased echogenicity within filum (arrowhead) posterior to L4 vertebral body.

View larger version (93K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —Fatty filum in 23-week-old boy with sacral dimple who is otherwise developmentally normal. Axial T1-weighted MR image confirms fat in filum as localized area of increased signal intensity (arrowhead).

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —Caudal regression syndrome in 3-day-old girl of diabetic mother. Longitudinal sonogram shows blunted distal cord (arrow), typical of caudal regression syndrome.

View larger version (70K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —Caudal regression syndrome in 3-day-old girl of diabetic mother. Sagittal T1-weighted MR image confirms blunted conus medullaris and associated fat in filum (arrow) as well as absence of sacrum and coccyx (arrowhead).

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —Subdural hematoma in febrile 2-month-old boy after multiple attempts at lumbar puncture. Longitudinal sonogram identifies hemorrhage as circumferential, echogenic material in subdural space (straight arrow) that displaces dura (curved arrows) from posterior elements (arrowhead) and collapses normal CSF-containing thecal sac.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —Subdural hematoma in febrile 2-month-old boy after multiple attempts at lumbar puncture. Transverse sonogram also reveals circumferential echogenic subdural blood (arrows) obliterating normal CSF, which contains thecal sac.

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