Abstract
Introduction
Neurogenic bladder with anorectal malformations (ARM) is a well-known yet understudied topic. Diffusion tensor imaging (DTI) is a special usage of MRI that can evaluate peripheric nerves. The aim of this study is to evaluate the lumbosacral plexuses of patients with ARM using DTI.
Patients and methods
Patients with ARM willing to participate were included. Patient files were reviewed, a questionnaire was made, and DTI was performed. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were computed for the right and left lumbosacral plexuses.
Results
There were 18 patients and 12 controls. Groups were similar in terms of sex (p = 0.232) and age (p = 0.853). There was a significant difference only for ADC of the left plexus. There was visible asymmetry in tractographies and DTI parameters of two patients with severely deformed pelvises (image 1) but also in another patient with a normal sacrum. In addition, despite asymmetry, FA and ADC were similar to controls also in these patients.
Conclusion
This is the first study presenting quantitative data about the lumbosacral plexus in ARM. We think the most interesting finding of this study was observing the normal values even in the patients with severely malformed sacrum which is yet to be validated with further studies.
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Funding
This work was supported by Aliye Uster Foundation (Izmir, Turkey) research scholarship. This is an independent organization funding educational and research activities in Ege University. The authors have no conflict of interest regarding the study.
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All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Sibel Tiryaki, Cenk Eraslan and Ulgen Celtik. The first draft of the manuscript was written by Sibel Tiryaki, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.
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Tiryaki, S., Celtik, U., Eraslan, C. et al. Diffusion tensor imaging in anorectal malformations: a pilot study for the evaluation of lumbosacral plexus. Pediatr Surg Int 38, 609–616 (2022). https://doi.org/10.1007/s00383-022-05077-3
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DOI: https://doi.org/10.1007/s00383-022-05077-3