Spina Bifida Protocol - Johns Hopkins Hospital€¦ · Spina Bifida Protocol • obtain coronal or...
Transcript of Spina Bifida Protocol - Johns Hopkins Hospital€¦ · Spina Bifida Protocol • obtain coronal or...
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Spina BifidaProtocol
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Spina Bifida Protocol • obtain coronal or parasagittaland number bony elements
• number bony elements either by starting at the bottom of the spine (S5) and count upwards as demonstrated above
OR• start at the last rib (T12) and count downwards
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Spina Bifida Protocol• transverse: last normal level• transverse: first abnormal level
demonstrating splayed element down to end of defect
• image whether skin covered or not; bony elements may appear splayed beyond non-skin covered elements
• obtain 3d images whenever possible (surface rendering / multi-planar views)
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Level at which defect begins (L5-S1)
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S1 S1
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S2S2
Sac in 3D
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S3 S3
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S4S4
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S5 S5
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(3Ds)
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Sequential views of defect – be sure to include the level above splayed level…
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Document the following:
• cerebellar displacement• cisterna magna (obliteration)• cortical mantle thickness (frontal
region)• lateral ventricles (measure)• hip, knee, ankle, toe movement
(videotape)• feet (clubbing, no clubbing)
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Measurement of lateral cerebral ventricles and dangling choroid
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Dangling choroid plexus
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Dangling choroid plexus
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Cerebellum with obliteration of the cisterna magna
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