[Value of magnetic resonance tomography in diagnosis of tethered cord syndrome in children].
The tethered cord syndrome is considered a trouble complex that is caused by fixation of the spinal cord by intra- or extradural components. Clinically it is characterized by motor and sensory dysfunction of the lower extremities, muscle atrophy, decreased or hyperactive reflexes, urinary and bowel incontinence, spastic gait, or orthopedic deformities. Traditionally, positive-contrast myelography has been the diagnostic procedure of choice, often supported by CT (post myelo-CT). With the improvement of surface-coil technology, MR imaging has become a useful diagnostic tool for the assessment of the spinal cord and canal without ionizing radiation. MR examinations of 80 patients with the clinical diagnosis of tethered spinal cord were reviewed retrospectively in order to define normal anatomy and pathological findings as well as to establish MR strategies in the diagnosis of tethered cord syndrome in children. In order to evaluate intraspinal lipomas, the width of the spinal canal and dysraphic lesions, T1-weighed sagittal and transverse images are useful. In case of deformities of the spinal column the corona slice orientation should be used. The filum terminale and its thickness is best seen in T2-weighed transverse and sagittal images. The extension of fat within the spinal canal over more then 6 vertebral bodies and more then 1.2 cm width could be an indication of a lipomatous malformation in the sacral spinal canal.