ABNORMAL ANATOMY OF THE LUMBOSACRAL REGION IMAGED BY MAGNETIC-RESONANCE IN CHILDREN WITH ANORECTAL-MALFORMATIONS

Objective-To investigate the frequency of lumbosacral anomalies, the a ssociation with urogenital abnormalities, and the correlation with def aecation pattern by magnetic resonance imaging (MRI). Methods-A prospe ctive analysis was performed of routine MRI in patients with anorectal malformations. Between 1990 and 1994, MRI was performed in 43 such pa tients: 31 boys and 12 girls. Twenty four had a high anorectal malform ation, 16 had a low anorectal malformation, and three had Currarino's triad. IMRI was performed before reconstruction in 26, and postoperati vely in 17. Urogenital anomalies were found in 21. Results-Abnormaliti es of the spinal cord and spine were found with MRI in 20 patients (46 .5%); caudal regression syndrome in 10, tethered cord in two, a combin ation of both in three, and other spinal anomalies in five. These anom alies were found in 30% of the patients with low anorectal malformatio ns, and in 50% with high anorectal malformations. In patients with uro genital malformations, MRT more often showed spinal anomalies (13/21, 62%) than in patients without (7/22, 32%). In high anorectal malformat ions, defaecation was more often a problem in patients with spinal ano malies (12/15, 80%) than in patients without (2/8, 25%). Conclusions-S pinal anomalies in the lumbosacral region were found with MRI in 46.5% of patients with anorectal malformations. Since presence of these ano malies seems to be related to clinical outcome, MRI should be performe d routinely in all such patients.