Ultrasonographic clues for diagnosis of spina bifida occulta in children

Emin Cakmakci, Hasibe Gokce Cinar, Cigdem Uner, Berna Ucan, Ayse Secil Eksioglu, Melek Pala, Yasemin Tasci Yildiz, Selma Cakmakci, Hulya Seker Yikmaz


Background: The aim of the current study was to find out if spinal ultrasonography might have a predictive potential for detection of spina bifida occulta (SBO) in pediatric nocturnal enuresis patients.
Methods: A total of 108 children (58 females, 50 males) with a mean age of 8 (range, 6–15) years diagnosed for nocturnal enuresis in our tertiary care center were included in this cross-sectional analysis. Half of the cases (n=54, 50%) were found to have SBO, while the other half did not have SBO. After obtaining radiographs and computed tomography examinations of L5-S1 vertebra, patients were examined by spinal ultrasound regarding radiologic clues which may aid in the detection of SBO.
Results: The clues of “single and double echogeneous cap signs and the V-shaped tip of spine” were found useful for diagnosing SBO at levels of L5 and S1 in pediatric patients suspected for SBO. Receiver operating curve (ROC) curve analysis of CT and ultrasonographic clues for diagnosis of SBO on S1 level revealed that these clues yielded a comparable diagnostic accuracy to CT. Areas under curve for CT and studied ultrasonographic clues were are 0.667±0.053 and 0.907±0.032 (P<0.001) respectively.
Conclusions: Ultrasonography seems to be a useful and practical diagnostic tool for diagnosing spina bifida. However, to implement our ultrasonographic criteria in routine radiological practice, further studies in larger series are warranted.