Skip to main content
SpringerLink
Log in

Localization of the fetal conus medullaris by oblique view extended imaging

  • Original Article
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the accuracy of oblique view extended imaging (OVEI) in locating the position of the fetal conus medullaris.

Methods

One hundred and twenty-two normal fetuses and five counterparts with spinal bifida received prenatal ultrasound examination. The vertebral body at the terminal of the conus medullaris and the coronal section of over five vertebral bodies were reconstructed using OVEI. Development of the nervous system of normal fetuses was assessed at postnatal day 28. For spinal bifida cases, pathological examination was performed.

Results

Among 127 fetuses, the conus medullaris was accurately positioned in 120 (94.0%) cases according to OVEI. OVEI failed to locate the conus medullaris in three healthy fetuses due to obesity of the mother and four cases with spinal bifida due to abnormal fetal position. The conus medullaris was located at L3 or above in 115 healthy fetuses. The conus medullaris was positioned below L4 in five fetuses with spinal bifida, including L5 in two, S1 in two, and S3 in one, which was consistent with the findings of pathological examination.

Conclusions

OVEI can display the 12th rib, T12, and conus medullaris simultaneously. OVEI is applicable to precisely locate the position of the conus medullaris and useful for prenatal evaluation of spinal bifida.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Hoopmann M, Sonek J, Schramm T, et al. Position of the conus medullaris in fetuses with skeletal dysplasia. Prenat Diagn. 2012;32:1313–7.

    Article  PubMed  Google Scholar 

  2. Zalel Y, Lehavi O, Aizenstein O, et al. Development of the fetal spinal cord: time of ascendance of the normal conus medullaris as detected by sonography. J Ultrasound Med. 2006;25:1397–401.

    Article  PubMed  Google Scholar 

  3. Solmaz I, Izci Y, Albayrak B, et al. Tethered cord syndrome in childhood: special emphasis on the surgical technique and review of the literature with our experience. Turk Neurosurg. 2011;21:516–21.

    PubMed  Google Scholar 

  4. Perlitz Y, Izhaki I, Ben-Ami M. Sonographic evaluation of the fetal conus medullaris at 20 to 24 weeks’ gestation. Prenat Diagn. 2010;30:862–4.

    Article  PubMed  Google Scholar 

  5. Lei T, Xie HN, Zheng J, et al. Prenatal evaluation of the conus medullaris position in normal fetuses and fetuses with spina bifida occulta using three-dimensional ultrasonography. Prenat Diagn. 2014;34:564–9.

    Article  PubMed  Google Scholar 

  6. Guide for prenatal ultrasound examination. Chin J Ultrasound Med. 2012;9:571–3.

  7. E ZS, Chen JH, Yu SM, et al. Study on ultrasonography of fetal spinal cord in late pregnancy. Chin J Med Imaging Technol. 2004;20:62–3.

    Google Scholar 

  8. Sohaey R, Oh KY, Kennedy AM, et al. Prenatal diagnosis of tethered spinal cord. Ultrasound Q. 2009;25:83–7.

    Article  PubMed  Google Scholar 

  9. Beek FJ, van Leeuwen MS, Bax NM, et al. A method for sonographic counting of the lower vertebral bodies in newborns and in fants. AJNR Am J Neuroradiol. 1994;15:445–9.

    CAS  PubMed  Google Scholar 

  10. Hajnovic L, Tranka J. Tethered spinal cord syndrome-the importance of time for outcom. Eur J Pediatr Surg. 2007;17:190–3.

    Article  CAS  PubMed  Google Scholar 

  11. Widjaja E, Whitby EH, Paley MN, et al. Normal fetal lumbar spine on postmortem MR imaging. AJR Am J Neuroradiol. 2006;27:553–9.

    CAS  Google Scholar 

  12. Huang YL, Wong AM, Liu HL, et al. Fetal magnetic resonance imaging of normal spinal cord: evaluating cord visualization and conus medullaris position by T2-weighted sequences. Biomed J. 2014;37:232–6.

    Article  PubMed  Google Scholar 

  13. Blas D. Fetal evaluation of spine dysraphism. Pediatri Radiol. 2010;40:1029–37.

    Article  Google Scholar 

  14. Yamada S, Lonser RR. Adult tethered cord syndrome. J Spinal Disord. 2000;13:319–23.

    Article  CAS  PubMed  Google Scholar 

  15. Bui CJ, Tubbs RS, Oakes WJ. Tethered cord syndrome in children: a review. Neurosurg Focus. 2007;23:E2.

    Article  PubMed  Google Scholar 

  16. Blondiaux E, Katorza E, Rosenblatt J, et al. Prenatal US evaluation of the spinal cord using high-frequency linear transducers. Pediat Radiol. 2011;41:374–83.

    Article  PubMed  Google Scholar 

  17. Hoopmann M, Abele H, Yazdi B, et al. Prenatal evaluation of the position of the fetal conus medullaris. Ultrasound Obstet Gynecol. 2011;38:548–52.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ultrasonic Department, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, No. 59 Xiangzhu Avenue, Nanning, 530002, Guangxi, China

    Shui-hua Yang, Zuo-jian Yang, Yuan-yuan Li, Huan Huang & Xiao-xian Tian

Authors
  1. Shui-hua Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zuo-jian Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuan-yuan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Huan Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiao-xian Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiao-xian Tian.

Ethics declarations

Ethical statements

This study was approved by the Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region and Children’s Hospital of Guangxi Zhuang Autonomous Region.

Conflict of interest

Shuihua Yang, Zuojian Yang, Yuanyuan Li, Huan Huang, and Xiaoxian Tian declare that they have no conflict of interest.

Funding

The study was supported by Guangxi research and development project of health appropriate Technology (S2013-0902).

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, Sh., Yang, Zj., Li, Yy. et al. Localization of the fetal conus medullaris by oblique view extended imaging. J Med Ultrasonics 44, 281–287 (2017). https://doi.org/10.1007/s10396-017-0773-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-017-0773-x

Keywords

Search

Navigation