- 作者：Owen Arthurs ; Sudhin Thayyil ; Angie Wade ; W.K. ¡®Kling¡¯ Chong ; Neil J. Sebire ; Andrew M. Taylor
- 关键词：LP ; lumbar puncture ; ASCD ; anterior spinal canal depth ; MSCD ; mid-spinal canal depth ; PSCD ; posterior spinal canal depth ; SCD ; spinal canal depth ; USS ; ultrasound ; MRI ; magnetic resonance imaging ; W ; weight
- 刊名：European Journal of Radiology
- 出版年：2012
- 出版时间：August, 2012
- 年：2012
- 卷：81
- 期：8
- 页码：e813-e816
- 全文大小：273 K
Objectives
Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI).Patients and methods
Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04 kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age.
Results
ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r > 0.8). A simple linear model MSCD (mm) = 3 ¡Á Weight (kg) + 5 was the best fit, identifying an SCD value within the correct range for 87.2 % (68/78) (95 % CI (78.0, 92.9 % )) cases. Gestational age did not add significantly to the predictive value of the model.
Conclusion
There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm) = 3 ¡Á Weight (kg) + 5 could result in fewer traumatic LPs in this population.