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Pediatric Imaging

E2964. Common Variants of Spinal Sonography in Normal Developing Neonates

Mehta A1,  Adler K.1,2 1. University of Missouri-Kansas City School of Medicine, Kansas City, MO; 2. Children's Mercy Hospital, Kansas City, MO

Address correspondence to A. Mehta (amehta792@gmail.com)

Background Information: Recent advances in sonography have improved image quality significantly enough to sufficiently characterize nearly all spinal anomalies in the first days of life. This allows for the clinical determination of whether the lesion requires urgent intervention or if further radiologic evaluation with studies such as MRI can be delayed until therapeutic intervention is more eminent; however, one must be familiar with an array of normal variants that may occur to prevent unnecessary further imaging, clinical referral, and worry. This educational exhibit will use a case-based approach to illustrate common pitfalls and normal variants that may simulate spinal anomalies. Educational objectives will focus on key imaging features, indications for follow-up, and clinical significance of common normal variants.

Educational Goals/Teaching Points: After reviewing this educational exhibit, the viewer should be able to describe the embryologic development and anatomy of the neonatal spine, list indications to screen with lumbar spine sonography, and state imaging features of various lumbar spine anomalies on neonatal ultrasound and the variants that can simulate anomalies.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Common normal variants to be aware of include a filar cyst, borderline low conus, ventriculus terminalis, prominent or fatty filum terminale, positional cauda equina pseudomass, dysmorphic coccyx, and pseudosinus tract of coccyx. This exhibit will review the imaging findings of each of these variants.

Conclusion: Many variants in the first month of life may be confused with spinal anomalies on lumbar ultrasound. It is important to identify imaging features of normal variants to prevent unnecessary intervention or further evaluation.