MRI evaluation of fetal tethered-cord syndrome: correlation with ultrasound findings and clinical follow-up after birth

•MRI provided more information than US to image the fetuses with tethered cord. •MRI was comparable with US in terms of the diagnostic performance of spina bifida. •Outcomes in the fetuses with tethered cord correlated with the complicated malformations. AIM The study aimed to describe the features of magnetic resonance imaging (MRI) in fetuses with tethered-cord syndrome (TCS) or lower spinal cord (LSC) and to analyse the clinical outcomes and complications during follow-up. MATERIALS AND METHODS This is a retrospective study of fetuses diagnosed with TCS or LSC using MRI from January 2015 to August 2019. The average gestational week (GW) at MRI examination was 25.46 ± 4.73 GW (range: 21–39 GW). MRI was used 1 Hertzler 2nd, D.A. DePowell J.J. Stevenson C.B. et al. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010; 29: E1 Crossref PubMed Scopus (136) Google Scholar to identify the anatomical landmarks of the spine 2 Tuite G.F. Thompson D.N.P. Austin P.F. et al. Evaluation and management of tethered cord syndrome in occult spinal dysraphism: recommendations from the international children's continence society. Neurourol Urodyn. 2018; 37: 890-903 Crossref PubMed Scopus (14) Google Scholar ; to measure the width of the conus medullaris and record the ending position of the LSC 3 Di Mascio D. Sileo F.G. Khalil A. et al. Role of magnetic resonance imaging in fetuses with mild or moderate ventriculomegaly in the era of fetal neurosonography: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019; 54: 164-171 Crossref PubMed Scopus (35) Google Scholar ; and to analyse other neurological deformities. The diagnostic results between MRI and ultrasonography (US) were compared. RESULTS A total of 38 fetuses with suspected intracranial or spinal lesions on US or MRI were included. Among all fetuses, 17 fetuses were diagnosed with LSC or TCS without associated anomalies. Twenty-one fetuses had complications of central nervous system (CNS) anomalies, one fetus also had a diagram hernia, and one fetus had an inverse foot. MRI provided more diagnoses than US in nine fetuses. Two cases of diastematomyelia detected on MRI were missed on US. The capability of MRI was comparable with that of US in terms of displaying spina bifida. CONCLUSION In the present study, fetal MRI showed better performance than US for depicting TCS and related CNS abnormalities. MRI provided clinicians with additional information in terms of prenatal counselling and management. The study aimed to describe the features of magnetic resonance imaging (MRI) in fetuses with tethered-cord syndrome (TCS) or lower spinal cord (LSC) and to analyse the clinical outcomes and complications during follow-up. This is a retrospective study of fetuses diagnosed with TCS or LSC using MRI from January 2015 to August 2019. The average gestational week (GW) at MRI examination was 25.46 ± 4.73 GW (range: 21–39 GW). MRI was used 1 Hertzler 2nd, D.A. DePowell J.J. Stevenson C.B. et al. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010; 29: E1 Crossref PubMed Scopus (136) Google Scholar to identify the anatomical landmarks of the spine 2 Tuite G.F. Thompson D.N.P. Austin P.F. et al. Evaluation and management of tethered cord syndrome in occult spinal dysraphism: recommendations from the international children's continence society. Neurourol Urodyn. 2018; 37: 890-903 Crossref PubMed Scopus (14) Google Scholar ; to measure the width of the conus medullaris and record the ending position of the LSC 3 Di Mascio D. Sileo F.G. Khalil A. et al. Role of magnetic resonance imaging in fetuses with mild or moderate ventriculomegaly in the era of fetal neurosonography: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019; 54: 164-171 Crossref PubMed Scopus (35) Google Scholar ; and to analyse other neurological deformities. The diagnostic results between MRI and ultrasonography (US) were compared. A total of 38 fetuses with suspected intracranial or spinal lesions on US or MRI were included. Among all fetuses, 17 fetuses were diagnosed with LSC or TCS without associated anomalies. Twenty-one fetuses had complications of central nervous system (CNS) anomalies, one fetus also had a diagram hernia, and one fetus had an inverse foot. MRI provided more diagnoses than US in nine fetuses. Two cases of diastematomyelia detected on MRI were missed on US. The capability of MRI was comparable with that of US in terms of displaying spina bifida. In the present study, fetal MRI showed better performance than US for depicting TCS and related CNS abnormalities. MRI provided clinicians with additional information in terms of prenatal counselling and management.