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Prenatal imaging of the normal and abnormal spinal cord: recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee

  • ESPR Belgrade 2023 - Postgraduate Course and Taskforce Lectures
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Abstract

Spinal dysraphisms are amenable to diagnosis in utero. The prognosis and the neonatal management of these conditions differ significantly depending on their types, mainly on the distinction between open and closed defects. A detailed evaluation not only of the fetal spine, but also of the brain, skull, and lower limbs is essential in allowing for the right diagnosis. In this article, recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee will be presented. The aim of this paper is to review the imaging features of the normal and abnormal fetal spinal cord, to clarify the prenatal classification of congenital spinal cord anomalies and to provide guidance in their reporting.

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Authors and Affiliations

  1. Department of Radiology, Sainte-Justine University Hospital, University of Montreal, Montreal, QC, H3T 1C5, Canada

    Juliette Garel

  2. Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy

    Andrea Rossi

  3. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

    Andrea Rossi

  4. Department of Radiology, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France

    Eléonore Blondiaux

  5. Department of Radiology and Fetal Medicine, Iris South Hospitals, 63 Rue J. Paquot, 1050, Brussels, Belgium

    Marie Cassart

  6. Department of Radiology, Tel Hashomer Hospital, Chaim Sheba Medical Center, Ramat-Gan, Israel

    Chen Hoffmann

  7. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Chen Hoffmann

  8. Department of Radiology, Hôpital d’Enfants Armand-Trousseau, AP-HP, Paris, France

    Catherine Garel

  9. National Reference Center for Rare Disease: Vertebral and Spinal Cord Anomalies (MAVEM Center), AP-HP, Trousseau Hospital, Paris, France

    Catherine Garel

Authors
  1. Juliette Garel
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Correspondence to Juliette Garel.

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Appendix

Appendix

Sample report template for a fetal ultrasound imaging study when facing spinal dysraphism: the items to be reported

GESTATIONAL AGE: [..]

FETAL POSITION: [..]

BIOMETRY:

Biparietal diameter (BPD) (*)

Head circumference (HC)

Abdominal circumference (AC)

Femur diaphysis length (FL)

FINDINGS:

Brain and skull

Chiari II malformation (*)

Flattening of frontal bones

Ventricular dilatation (*)

Presence of sub-ependymal heterotopia (*)

Dysgenesis of the corpus callosum (*)

Spine

Superior level of the defect (the upper point at which the posterior arches are open)

Level of the conus medullaris (*)

Shape of the conus medullaris (*)

Visualisation of the neural placode (*)

Position of the neural placode (flush, inside or outside the spinal canal) (*)

Presence or absence of a sac (*)

Nerve roots inside the sac

Peripheral lining (thin or thick) (*)

Morphology of the vertebrae (normal, parallel or inverted)

The spinal curvature (*)

Spinal canal focal widening (*)

Abnormal echogenicity within the spinal canal

Appearance of the posterior soft tissues

Lower limbs

Position of the inferior limbs and feet

Muscular atrophy of the lower limbs

Movements of the lower limbs during the US

CONCLUSION: [..]

(*): Information that can be complemented by magnetic resonance imaging. US ultrasound

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Garel, J., Rossi, A., Blondiaux, E. et al. Prenatal imaging of the normal and abnormal spinal cord: recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee. Pediatr Radiol 54, 548–561 (2024). https://doi.org/10.1007/s00247-023-05766-8

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