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Optimal Timing of Spinal Ultrasound Evaluations for Sacral Dimples in Neonates: Earlier May Not Be Better

Title
Optimal Timing of Spinal Ultrasound Evaluations for Sacral Dimples in Neonates: Earlier May Not Be Better
Authors
Cho, Hyun-HaeLee, So MiYou, Sun Kyoung
Ewha Authors
조현혜
SCOPUS Author ID
조현혜scopus
Issue Date
2019
Journal Title
JOURNAL OF ULTRASOUND IN MEDICINE
ISSN
0278-4297JCR Link

1550-9613JCR Link
Citation
JOURNAL OF ULTRASOUND IN MEDICINE vol. 38, no. 5, pp. 1241 - 1247
Keywords
dimpleneonatepediatricsspinal ultrasound
Publisher
WILEY
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Objectives A spinal ultrasound (US) evaluation during the immediate postnatal period may have limited ability in evaluating filum thickness because of the spinal cord pulsation caused by a crowded subarachnoid space and the cerebrospinal fluid deficiency during this period. This study aimed to determine the optimal timing of spinal US to evaluate sacral dimples in neonates. Methods This study included 585 neonates who had a clinically suspicious sacral dimple and underwent spinal US examinations between January 2015 and August 2017. Patients were classified into 1 of 2 groups based on whether measurements of all parameters were possible (group A) or not (group B). Neonatal and maternal clinical factors, including the antenatal history and US parameters, were compared between groups. Results Group A included 443 patients, and group B included 82. Patients in group B were significantly younger (6.2 versus 31.0 days), had a younger corrective age (38.9 versus 42.5 weeks), and had a smaller body weight (3.1 versus 4.6 kg) than those in group A (all P < .005). However, no statistically significant differences were found in other patient or maternal factors (P > .05 for all). The pulsation of the conus medullaris and nerve roots of the cauda equina (14.6% versus 100%), thickening and echogenicity of the filum terminale (2.4% versus 100%), and the presence of a normal subarachnoid space (18.3% versus 100%) were significantly more difficult to detect in group B than in group A (all P < .001). Conclusions For an accurate evaluation, which can reduce unnecessary confusion and costs, spinal US can be delayed until neonates grow beyond 31 days, with a corrected age of older than 42.5 weeks and body weight of greater than 4.6 kg.
DOI
10.1002/jum.14803
Appears in Collections:
의과대학 > 의학과 > Journal papers
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