Eur. Radiol. 1,139-144 (1991) © Springer-Verlag 1991 European Radiology Pediatric radiology MRI in spinal lumbosacral dysraphism Ph. Demaerel 1, G. Wilms 1 , C. Raaijmakers 1, C. Verpoorten 2, P. Casaer 2, C. Plets 3, and A. L. Baert 1 Departments of Radiology I, Paediatrics 2,and Neurosurgery3,University Hospitals K.U. Leuven, Herestraat 49, B-3000 Leuven, Belgium retains a role in routine screening and intraoperative im- aging. Introduction The term spinal dysraphism (SD) covers congenital spine abnormalities in which there is a disorder of midline fusion of mesenchymal, bony and neural structures [1]. This paper is only concerned with lumbosacral SD. This can be subdivided into spina bifida occulta (SBO) and spina bifida aperta (SBA). These can occur as isolated anomalies or in combination with other dysraphic states [2-4]. The clinical features of SBO and SBA are very similar and include back pain and/or progressive neurological de- fect (walking difficulties, foot deformity, bladder dysfunc- tion) [5]. In SBO, examination often reveals skin lesions in the lumbosacral region. Treatment is surgical and should be carried out as soon as the diagnosis is established. Early surgery, with release of the spinal cord may prevent pro- gressive neurological deterioration [6]. The magnetic resonance findings in 30 patients with lumbar spinal dysraphism are presented. Surgical cor- relation was obtained in 9 patients. The conclusion to be drawn from the literature (in which over 200 cases have been reported) is that MRI should be the pro- cedure of choice when surgery is considered. Sonography Offprint requests to: G. Wilms Methods Thirty patients (13 male, 17 female) aged from 4 months to 44 years (mean age 9 years) were studied by MRI be- tween 1987 and 1990. Plain radiographs of the spine were obtained in all patients, and myelography was performed in 3. The final diagnoses are listed in Table 1. Nine MR examinations were performed a few weeks before surgery, and 8 more than 2 years after surgery; 13 patients did not Fig.1. Meningomyelocele: postoperative imaging [sagittal T1- weighted image (455/15)]. Tethering of the spinal cord in scar tissue and subcutaneous fat (arrowhead)