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Original research article


Magnetic Resonance Imaging Analysis of Caudal Regression Syndrome and Concomitant Anomalies in Pediatric Patients.

Deb K BoruahDhaval D DhinganiSashidhar AcharArjun PrakashAntony AugustineShantiranjan SanyalManoj GogoiKangkana Mahanta
Departments of Radiodiagnosis and Pediatric Surgery, Assam Medical College, Dibrugarh, AssamDepartment of Radiodiagnosis, NIMHANS, Bengaluru, KarnatakaDepartment of Radiodiagnosis, RML and PGIMER, New Delhi, India
Date of Submission: 02-Jun-2016, Date of Acceptance: 17-Aug-2016, Date of Web Publication: 20-Sep-2016.
Corresponding Author:
Corresponding Author

Deb K Boruah

RCC‑4, M‑Lane, Assam Medical College Campus, Dibrugarh, Assam ‑ 786 002, India.
E-mail: drdeb_rad@yahoo.co.in

Corresponding Author:
Corresponding Author

Deb K Boruah

RCC‑4, M‑Lane, Assam Medical College Campus, Dibrugarh, Assam ‑ 786 002, India.
E-mail: drdeb_rad@yahoo.co.in

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ABSTRACT



Objective: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of caudal regression syndrome (CRS) and concomitant anomalies in pediatric patients.
Materials and Methods: A hospital-based cross‑sectional retrospective study was conducted. The study group comprised 21 pediatric patients presenting to the Departments of Radiodiagnosis and Pediatric Surgery in a tertiary care hospital from May 2011 to April 2016. All patients were initially evaluated clinically followed by MRI.
Results: In our study, 21 pediatric patients were diagnosed with sacral agenesis/ dysgenesis related to CRS. According to the Pang’s classification, 2 (9.5%) patients were Type I, 5 (23.8%) patients were Type III, 7 (33.3%) patients were Type IV, and 7 (33.3%) patients were of Type V CRS. Clinically, 17 (81%) patients presented with urinary incontinence, 6 (28.6%) with fecal incontinence, 9 patients (42.9%) had poor gluteal musculatures and shallow intergluteal cleft, 7 (33.3%) patients had associated subcutaneous mass over spine, and 6 (28.6%) patients presented with distal leg muscle atrophy. MRI showed wedge-shaped conus termination in 5 (23.8%) patients and bulbous conus termination in 3 (14.3%) patients above the L1 vertebral level falling into Group 1 CRS while 7 (33.3%) patients had tethered cord and 6 (28.6%) patients had stretched conus falling into Group 2 CRS.
Conclusion: MRI is the ideal modality for detailed evaluation of the status of the vertebra, spinal cord, intra- and extra-dural lesions and helps in early diagnosis, detailed preoperative MRI evaluation and assessing concomitant anomalies and guiding further management with early institution of treatment to maximize recovery.
Keywords: Lipomeningomyelocele, Magnetic Resonance Imaging, Sacral Agenesis, Tethered Cord

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