Outcome of ultrasonographic imaging in infants with sacral dimple

Jin Hyuk Choi, Taekwan Lee, Hyeok Hee Kwon, Sun Kyoung You, Joon Won Kang, Jin Hyuk Choi, Taekwan Lee, Hyeok Hee Kwon, Sun Kyoung You, Joon Won Kang

Abstract

Purpose: Sacral dimples are a common cutaneous anomaly in infants. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. The aim of this study was to determine the clinical manifestations in patients with an isolated sacral dimple and to review the management of spinal cord abnormalities identified with USG.

Methods: We reviewed clinical records and collected data on admissions for a sacral dimple from March 2014 through February 2017 that were evaluated with spine USG by a pediatric radiologist. During the same period, patients who were admitted for other complaints, but were found to have a sacral dimple were also included.

Results: This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52.8±42.6 days). Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. Follow-up spine USG was performed in 28 patients, which showed normalization or insignificant change.

Conclusion: In this study, all but one infant with a sacral dimple had benign imaging findings. USG can be recommended in infants with a sacral dimple for its convenience and safety.

Keywords: Diagnostic imaging; Infant; Lumbosacral region; Skin abnormalities; Ultrasonography.

Conflict of interest statement

Conflicts of interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1. Flow diagram showing the enrollment…
Fig. 1. Flow diagram showing the enrollment of patients with a sacral dimple. CNS, central nervous system.
Fig. 2. Ultrasonography (USG) findings in patients.…
Fig. 2. Ultrasonography (USG) findings in patients. (A) Normal lumbar spine USG in a 4-day-old boy. Longitudinal USG shows normal anatomy of the spinal canal and its contents. (B) Low-lying spinal cord in a 4-day-old girl. (B1) Longitudinal USG shows the tip of the conus medullaris terminating at L3–4 disc space. (B2) Sagittal T2-weighted magnetic resonance imaging confirms the level of the conus medullaris at the L3–4 disc space. (C) Echogenic filum terminale. (C1) Prominent filum terminale in a 6-month-old boy. Longitudinal USG shows hyperechoic filum terminale with normal thickness (about 1.3 mm). (C2) Thick filum terminale in a 5-month-old boy. Longitudinal USG shows hyperechoic filum terminale with 2.2-mm thickness. (D) Filar cyst (arrow in D1 and D2) in a 1-month-old boy. Longitudinal (D1) and transverse (D2) USG shows well-defined, thin walled, fusiform cyst below the tip of the conus medullaris.
Fig. 3. Age at first visit to…
Fig. 3. Age at first visit to the hospital.

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