Prenatal diagnosis of fetal diastematomyelia: presentation of two cases Fetal diastematomiyelinin prenatal tanısı: iki olgu sunumu (original) (raw)

Prenatal diagnosis of diastematomyelia: presentation of eight cases and review of the literature

Ultrasound in Obstetrics and Gynecology, 2007

Objectives Diastematomyelia is a rare form of spinal dysraphism. We present eight cases of diastematomyelia diagnosed prenatally in our institution as well as a review of the literature in order to determine the prognosis of isolated cases of this very unusual condition. Methods Records of fetuses with diastematomyelia diagnosed in our institution between January 2000 and June 2005 were collected. All liveborn fetuses were examined by a pediatric neurologist. Pre-and postnatal data were analyzed. A search was then conducted using PubMed to review previously reported cases in the literature. Results Eight cases of diastematomyelia were diagnosed during the study interval. The mean (range) gestational age at diagnosis was 21 (13-25) weeks. The main sonographic findings were widening of the spinal canal in the coronal view and an additional echogenic focus in the posterior part of the spinal column in the axial view. The diagnosis of associated open spina bifida was made in one fetus with elevated levels of amniotic fluid α-fetoprotein (AF-AFP) and acetylcholinesterase (AF-AChE) and the pregnancy was terminated. The other seven cases of diastematomyelia had normal levels of AF-AFP and AF-AChE and were considered isolated. One pregnancy miscarried spontaneously 1 week following amniocentesis and the remaining six were delivered at term. Review of the literature revealed 14 reports involving 26 cases of prenatally diagnosed diastematomyelia. Twelve cases had normal biochemistry and/or no additional abnormalities and all had a favorable outcome. Conclusions When diastematomyelia is not associated with other spinal anomalies, the prognosis is favorable. Prenatal diagnosis is generally made in the second trimester but sonographic signs may be recognized as early as the first trimester. Intrauterine diagnosis of diastematomyelia should facilitate appropriate management of affected cases.

Prenatal Diagnosis of Diastematomyelia: Case Reports and Review of the Literature

Prenatal Diagnosis, 1997

Diastematomyelia is a rare malformation characterized by complete or incomplete division of the spinal cord by osseous or fibrocartilaginous septum. Most cases are seen in association with other anomalies of the vertebral column such as spina bifida, kyphoscoliosis, butterfly vertebra, and hemivertebra. In this report we describe two cases of isolated diastematomyelia detected at routine second-trimester detailed ultrasound scan, the most striking feature being the detection of an echogenic focus in the posterior aspect of the spine in association with widening of the interpedicular vertebral space. The prenatal literature is reviewed to assess the clinical significance of this finding. 1997 by John Wiley & Sons, Ltd.

Fetal Diastematomyelia: Rare Case

IOSR Journal of Dental and Medical Sciences, 2012

A ten-month-old infant with Diastematomyelia, as a very rare variety of spinal dysraphism is presented in this article Routine USG in a 36 weeks pregnant woman revealed a spinal abnormality of the fetus in thoracolumbar [D12-L1] regions. At birth, examination of the newborn showed a small midline swelling and bluish discoloration of skin and scoliosis in the lumbar region. There was associated umbilical hernia.no neurological deficit was noted. Postnatally 8 month plane radiograph showed multiple deformed dorsal vertebrae and mild scoliosis.MR imaging revealed diastematomyelia was seen at thoracolumbar [D12-L1] regions. It was type I with a bony spur measuring 1.0 X0.5 cm the two hemicords were asymmetrical. There was no cord tethering. The conus ended at the L4 level.. There was associated thoracolumbar spina bifida measuring 1.6 cm with a small meningocele measuring 2.5 X 0.6 cm. multilevel syringohydromelia and multiple deformed dorsal vertebrae and mild scoliosis of dorsal spine was seen. Thus what makes this case different is inspite of having so many microanatomical defects, there is no neurologic deficit. So its advisible to do corrective surgery to avoid further complicatiions-thethered cord syndrome before the baby starts to take steps.

Prenatal diagnosis of diastematomyelia: A case report and review of the literature

Journal of Clinical Ultrasound, 2012

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.

Second trimester diagnosis of diastematomyelia: US, CT and MRI features

International Journal of Pregnancy & Child Birth, 2018

Diastematomyelia is a rare spinal malformation characterized by a sagittal division of the spinal cord. Prenatal diagnosis of this malformation is possible by ultrasound, MRI and CT. In this report we describe a case of fetal diastematomyelia assessed by 2D and 3D ultrasound, MRI, CT scan and X-Ray.

Diastematomyelia: pre- and postnatal multimodal diagnostic approach

Journal of the Belgian Society of Radiology, 2011

Diastematomyelia is a relatively rare congenital abnormality presenting as a sagittal separation of the spinal cord. Although cases of diastematomyelia have been previously reported, fully documented approaches by both prenatal and postnatal diagnostic workup are rare in the literature. We present a fully studied case of diastematomyelia type I investigated by prenatal US and MRI and postnatal US, MRI and radiography.

Fetal diastematomyelia: MR imaging: A case report

Indian Journal of Radiology and Imaging, 2009

MRI is increasingly being used in the diagnosis of fetal anomalies suspected on USG. The USG evaluation of fetal spinal anomalies is limited by acoustic shadowing, fetal position and the amount of liquor. Fetal MRI is able to show spinal anomalies well, as in our case of fetal diastematomyelia with a dorsal dermal sinus, suspected on USG at 28 weeks gestation.

Prenatal diagnosis of closed spina bifida: multicenter case series and review of the literature

Journal of Maternal-fetal & Neonatal Medicine, 2018

Objective: Closed spina bifida (CSB) is an abnormality of the posterior arch formation in which the defect is covered by the skin, without protrusion of nervous tissue. The prenatal diagnosis of CSB is very difficult, rarely diagnosed antenatelly. Methods: We present a multicenter case series of six prenatal diagnosis of CSB using two-dimensional (2D) ultrasonography complemented with three-dimensional (3D) ultrasonography and magnetic resonance imaging (MRI). All cases of prenatal diagnosis of CSB were confirmed in the postnatal period/termination of pregnancy by both clinical and/or imaging diagnosis (ultrasonography and MRI). Results: 2D ultrasonography allowed the prenatal diagnosis of six cases. We observed two cases of subcutaneous lipomas, two cases of meningoceles, one case of fibrolipomas, and one case of false-positive CSB (meningomielocele). 3D ultrasonography using rendering mode was important in one case of meningocele (case#3). Three cases were delivered at term and one of them was submitted to corrective surgery. All these three newborns were discharged from the hospital well and without neurologic signs. Termination of pregnancy was performed in three cases. Conclusion: During prenatal evaluation, detailed ultrasonographic assessment of the entire spine with the identification of the position and morphology of the conus medullaris, and absence of cranial signs of spinal dysraphism are the most valuable sonographic clues for the diagnostic of the CSB.

MRI diagnosis of diastematomyelia in a 78-year-old woman: Case report and literature review

Polish journal of radiology / Polish Medical Society of Radiology, 2010

Diastematomyelia is a rare congenital malformation of the spinal cord, which belongs to the group of occult spinal dysraphisms. This disorder consists in the separation of the spinal cord into two parts in the sagittal plane (hemicords). Diastematomyelia may coexist with other spinal dysraphisms, such as myelomeningocele, meningocele, spinal lipoma, neuroenteric cysts or dermal sinuses and vertebral abnormalities, such as hemivertebrae, butterfly vertebrae or scoliosis. We reported a case of a woman with a congenital defect of the spinal cord, in the form of diastematomyelia, which was diagnosed at the age of 78. The patient had been complaining of back pain for many years. The X-ray radiograms showed the fusion of vertebra L3-L4, defective fusion of posterior spinal bony elements L5-S1. Moreover, abnormal hair growth (hypertrichosis) in the lumbar region was found. The separation of the spinal cord was only diagnosed in MR imaging which was performed at the age of 78. Diastematomye...