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Child's Nervous System
Published in: Child's Nervous System 1/2021

01-01-2021 | Magnetic Resonance Imaging | Original Article

Utility of CISS imaging in the management of tethered cord syndrome

Authors: Shilpa Sankhe, Garima Dang, Shobhit Mathur, Dattatraya Muzumdar

Published in: Child's Nervous System | Issue 1/2021

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Abstract

Objective

To compare the utility of constructive interference in steady-state (CISS) sequence over T2-weighted (T2W) sequence in the accurate delineation of the tethering element on magnetic resonance (MR) imaging in patients of tethered cord syndrome (TCS) and correlation with intraoperative findings.

Methods

MR findings of fifty-six consecutive patients with operative findings of TCS were studied. The intraoperative findings of all patients were studied and compared with the preoperative imaging findings on T2W imaging and CISS images.

Results

CISS images provided more information than T2W imaging. The overall sensitivity of CISS in MR evaluation of patients with TCS was higher (99.17%) as compared with the T2W sequence (71.48%) especially in the detection of precise position/extent of tethered cord, assessment of filum terminale thickening, detection of a fibrous spur in cases of split cord malformation, detection of dorsal dermal sinus, and evaluation of its precise extent and ramifications. The area under the ROC curve was higher with CISS (0.99) than with T2W sequence (0.85) which reflects its good predictive value as a screening test. This information was useful to the operating surgeon.

Conclusion

CISS sequence for imaging TCS can help enhance the overall surgical outcome of the patients ensuring completeness of the surgery. CISS should be routinely performed in the work-up of patients with tethered cord syndrome.
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Metadata
Title
Utility of CISS imaging in the management of tethered cord syndrome
Authors
Shilpa Sankhe
Garima Dang
Shobhit Mathur
Dattatraya Muzumdar
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 1/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04789-y

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