Diagnostic techniques and detailed assessment of fetal intraspinal lipoma: a prospective study.

PURPOSE: To explore the technical methods and advantages of prenatal diagnosis of fetal intraspinal lipomas.

METHODS

This was a prospective study. From August 2018 to August 2024, 315 fetuses suspected of having spinal neural tube malformations after conducting prenatal ultrasound were treated at the Neurosurgery Outpatient Department of the First Medical Center of the PLA General Hospital. Fetal magnetic resonance imaging (MRI) examinations were performed within 72 h after the ultrasound diagnosis. A total of 186 singleton pregnancies where fetuses have already been born were selected. MRI was performed within 1 month after birth. Using postnatal MRI as the gold standard, 58 fetuses diagnosed with intraspinal lipoma through postnatal MRI were selected. The diagnostic coincidence rates of prenatal ultrasound and fetal MRI in the prenatal diagnosis of intraspinal lipomas were analyzed.

RESULTS

Prenatal ultrasound correctly diagnosed 35 cases (35/58, 60.3%), and fetal MRI correctly diagnosed 49 cases (49/58, 84.5%). This difference was statistically significant (P = 0.004). Among the 58 cases of fetal intraspinal lipomas, 11 were of caudal type (11/58,19.0%), eight of dorsal type (8/58, 13.8%), ten of transitional type (10/58, 17.2%), 23 of mixed type (23/58, 39.7%), and six of lipoma myelomeningocele type (6/58, 10.3%). Among these, ten cases (10/58, 17.2%) were correctly diagnosed by prenatal ultrasound and 25 (25/58, 43.1%) using fetal MRI. This difference was statistically significant (P = 0.002).

CONCLUSIONS

Fetal MRI can accurately diagnose intraspinal lipomas and has diagnostic value for different types of intraspinal lipomas.