Intraspinal and Urogenital Abnormalities in Infants with Sacral Cutaneous Lesions
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Purpose: Sacral cutaneous lesions, such as dimples and hairy patches, may be associatedwith occult spinal dysraphism and urogenital abnormalities. This study aim to delineate high risk infants who need early screening for intraspinal and urogenital abnormalities by identifying the association between cutaneous lesions and combinedabnormalities. Methods: Sacral ultrasonography was performed in 777 infants with sacral cutaneouslesions from January 2010 to July 2014. Of these, 317 infants underwent abdominalultrasonography for urogenital abnormalities. We reviewed the patient's medical records and radiographic findings retrospectively. Results: Of the 777 infants, abnormal intraspinal findings such as tethered cord or meningocele were reported in 26 (3.4%). Sixteen of these 26 patients with abnormal findings underwent follow-up ultrasonography or MRI; 4 infants were diagnosed with lipomeningomyelocele through MRI, and 1 infant underwent a neurosurgical procedure. Among the 317 infants who underwent abdominal ultrasonography, 78 infants (24.6%) had congenital hydronephrosis and 8 infants (2.5%) had other urogenitalabnormalities including duplication of kidney, vesicoureteral reflux, horseshoekidney, renal cyst, or multicystic dysplastic kidney. Urogenital abnormalitieswere more common in patients with sacral dimples associated with hair or deviated gluteal folds than in those with simple dimples (OR 3.24 and 8.88; P=0.007 and P=0.001, respectively). Conclusion: Midline sacral cutaneous lesions may be associated with occult spinal dysraphism and urogenital abnormalities. To detect intraspinal lesions, ultrasonographyis recommended for infants with sacral cutaneous lesions. Likewise, infants with sacral dimples associated with either hair or deviated gluteal folds, should be evaluated via abdominal ultrasonography to assess for combined urogenital abnormalities.
Abstract
Purpose: Sacral cutaneous lesions, such as dimples and hairy patches, may be associatedwith occult spinal dysraphism and urogenital abnormalities. This study aim to delineate high risk infants who need early screening for intraspinal and urogenital abnormalities by identifying the association between cutaneous lesions and combinedabnormalities. Methods: Sacral ultrasonography was performed in 777 infants with sacral cutaneouslesions from January 2010 to July 2014. Of these, 317 infants underwent abdominalultrasonography for urogenital abnormalities. We reviewed the patient's medical records and radiographic findings retrospectively. Results: Of the 777 infants, abnormal intraspinal findings such as tethered cord or meningocele were reported in 26 (3.4%). Sixteen of these 26 patients with abnormal findings underwent follow-up ultrasonography or MRI; 4 infants were diagnosed with lipomeningomyelocele through MRI, and 1 infant underwent a neurosurgical procedure. Among the 317 infants who underwent abdominal ultrasonography, 78 infants (24.6%) had congenital hydronephrosis and 8 infants (2.5%) had other urogenitalabnormalities including duplication of kidney, vesicoureteral reflux, horseshoekidney, renal cyst, or multicystic dysplastic kidney. Urogenital abnormalitieswere more common in patients with sacral dimples associated with hair or deviated gluteal folds than in those with simple dimples (OR 3.24 and 8.88; P=0.007 and P=0.001, respectively). Conclusion: Midline sacral cutaneous lesions may be associated with occult spinal dysraphism and urogenital abnormalities. To detect intraspinal lesions, ultrasonographyis recommended for infants with sacral cutaneous lesions. Likewise, infants with sacral dimples associated with either hair or deviated gluteal folds, should be evaluated via abdominal ultrasonography to assess for combined urogenital abnormalities.
참고문헌 (32)
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