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Determining the optimal timing of screening spinal cord ultrasonography to detect filum terminale lipoma in infants

Ultrasonography 2020년 39권 4호 p.367 ~ 375
Albakheet Salman S., 윤혜성, 이미정, 김명준, 박은경, 심규원, 김동석, 은호선, 한경화, 신현주,
소속 상세정보
 ( Albakheet Salman S. ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
윤혜성 ( Yoon Hae-Sung ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
이미정 ( Lee Mi-Jung ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
김명준 ( Kim Myung-Joon ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
박은경 ( Park Eun-Kyung ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
심규원 ( Shim Kyu-Won ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
김동석 ( Kim Dong-Seok ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatric Neurosurgery
은호선 ( Eun Ho-Sun ) - Yonsei University College of Medicine Severance Children’s Hospital Department of Pediatrics
한경화 ( Han Kyung-Hwa ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
신현주 ( Shin Hyun-Joo ) - Yonsei University College of Medicine Severance Hospital Department of Radiology

Abstract


Purpose: The purpose of this study was to identify the optimal timing for screening spinal cord ultrasonography (US) to detect filum terminale lipoma in infants.

Methods: We retrospectively reviewed infants (<12 months old) who underwent repeated spinal cord US between April 2011 and January 2019. We excluded infants if they only had one US examination, or if they had lesions other than filum terminale lipoma. Infants with filum terminale lipoma on magnetic resonance imaging were included in the lipoma group and the others in the control group. A linear mixed model was used to assess differences in the growth pattern of filum terminale thickness by age and group. The cutoff thickness on US and its diagnostic performance were assessed according to age.

Results: Among 442 infants with 901 US examinations, 46 were included in the lipoma group and 58 in the control group. Sixty-seven infants had unmeasurable filum terminale thickness on initial US, including 55 neonates (82.1%) before 1 month of age. The lipoma group had significantly greater filum terminale thickness than the control group (P<0.001). Thickness increased with age in the lipoma group (P=0.027). The sensitivity of US was 87.5% and the area under the receiver operating characteristic curve was 0.949 (95% confidence interval, 0.849 to 0.991) with a cutoff value of 1.1 mm in 4- to 6-month-old infants.

Conclusion: Screening spinal cord US could effectively diagnose filum terminale lipoma in 4- to 6-month-old infants with a cutoff thickness of 1.1 mm. Spinal cord US can be used to screen young infants with intraspinal abnormalities.

키워드

Infants; Spinal cord; Ultrasonography; Cauda equina; Retrospective studies

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