MAGNETIC RESONANCE IMAGING IN CHILDREN WITH VOIDING DYSFUNCTION: IS IT INDICATED?
| Autor: | Gianpaolo Capolicchio, José L. Montes, Olivier Vernet, A.M. Houle, Joao L. Pippi Salle, Roman Jednak, Augustin M. O'Gorman, Jean-Pierre Farmer |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Sacrum medicine.medical_specialty Adolescent Urology Anorectal anomalies Urinary incontinence Vesicoureteral reflux Dyssynergia medicine Back pain Humans Child Coccyx Lumbar Vertebrae medicine.diagnostic_test Encopresis business.industry Magnetic resonance imaging Hyporeflexia Enuresis medicine.disease Magnetic Resonance Imaging Surgery Urinary Incontinence Child Preschool Female medicine.symptom business |
| Zdroj: | Journal of Urology. 160:1080-1083 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/s0022-5347(01)62702-2 |
| Popis: | We evaluated the role of magnetic resonance imaging (MRI) of the lumbosacral spinal cord in children with complicated voiding dysfunction and normal neuro-orthopedic examination.We reviewed the records of 32 consecutive children with complicated enuresis who were referred for neurosurgical evaluation, including those with a history of refractory voiding dysfunction or incontinence associated with persistent vesicoureteral reflux, encopresis, or associated leg or back pain. Nine patients were excluded from study because of urethral or anorectal anomalies, or failure to meet the inclusion criteria. Eligible for study inclusion were 23 children with a mean age of 8.9 years. Complete neurological and orthopedic examinations were normal in all patients except 1 with mild scoliosis and 1 with congenital facial palsy.Urodynamic studies revealed instability in 14 cases, hypertonia in 7, hyporeflexia in 2 and detrusor-sphincter dyssynergia in 4. Skeletal abnormalities, mostly spina bifida occulta, were detected in 16 of the 23 children (70%). Spinal MRI was normal in 21 patients (91.3%), including 1 with a tethered cord and lipoma associated with a complex skeletal abnormality, and 1 with a nonprogressive, nonsurgical T7 to T9 syrinx. Only the case of lipoma required neurosurgical intervention.The value of MRI is limited in children with voiding dysfunction and a normal neuro-orthopedic assessment. This study should be reserved for patients with associated neuroorthopedic findings or complex skeletal deformity on plain x-ray. |
| Databáze: | OpenAIRE |
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