Einstein (São Paulo) (Sep 2006)
Myelodysplasia in children with anorectal malformations
Abstract
Objective: To compare computed tomography and magneticresonance imaging accuracy to diagnose myelodysplasia inpatients with anorectal anomaly, to verify the prevalence of tetheredspinal cord, and to investigate if there is a direct relation betweenthe presence of myelodysplasia and type of anorectal anomaly,bone alteration, functional prognosis and associated malformationsin these patients. Methods: Thirty five patients with anorectalanomaly were studied using computed tomography and magneticresonance imaging of lumbosacral spine. Myelodysplasia wasanalyzed in terms of spinal computed tomography findings, type ofanorectal anomaly, sacral alterations, presence of associatedanomalies and fecal and urinary continence. Results: Magneticresonance imaging showed myelodysplasia in 45% of patients,and computed tomography provided correct diagnosis of the spinalcondition in only 66% of subjects. Myelodysplasia was observedeven in low anorectal anomalies. No association was found betweenmyelodysplasia in magnetic resonance imaging and presence ofvertebral alterations; associated anomalies; fecal and urinarycontinence. Prevalence of tethered spinal cord was of 14%.Conclusions: The best exam to diagnose myelodysplasia ismagnetic resonance imaging. Vertebral malformations, urinary andfecal continence and presence of associated anomalies were notgood indicators of myelodysplasia, but they could indicate tetheredspinal cord.
