Article Figures & Data
Figures
- Fig 1.
Sagittal T2-weighted MR image of a patient with MFS showing a huge anterior meningocele herniating into the pelvis through a large sacral defect (arrows). The urinary bladder (asterisk) is compressed anteriorly.
- Fig 2.
Coronal T2-weighted MR image showing lateral meningoceles/herniations (arrows) of the nerve root sleeves at level S1 in a patient with MFS.
- Fig 3.
A and B, T2-weighted sagittal MR images of a patient with MFS showing craniocaudal and AP measurements of the vertebral bodies (white arrows, A and B) and AP measurements of the dural sac (black arrows, B). Scalloping is present at levels L5, S1, and S2.
- Fig 4.
ROC curves of DSR at levels L3-S1. Graph shows sensitivity versus (1-specificity) of DSR as a marker of MFS at levels L3-S1 when comparing Ghent-positive patients independent of DE and controls.
Tables
- Table 1:
Characteristics of the 4 study groups or the number and percentage of patients with the condition*
Characteristics Ghent Independent of DE (n = 73) Ghent Dependent on DE (n = 14) Not Fulfilling Ghent (n = 18) Control (n = 101) P Value Age (mean ± SD) 39.4 (12.2) 40.6 (17.1) 36.1 (13.4) 39.6 (12.9) .74 Females (No.) (%) 45 (61.6) 11 (78.6) 11 (61.6) 64 (63.4) .68 DSR L3 (mean ± SD) 0.50b,c (0.11), n = 69 0.53c (0.06) 0.43a (0.08), n = 14 0.45a,b (0.07) <.001 DSR L4 (mean ± SD 0.50b (0.12), n = 72 0.51b (0.07) 0.41a (0.06) 0.43a (0.07) <.001 DSR L5 (mean ± SD) 0.57b (0.18), n = 68 0.65b (0.20) 0.39a (0.09) 0.42a (0.08) <.001 DSR S1 (mean ± SD) 0.94b (0.69), n = 61 1.02b (0.77), n = 13 0.40a (0.12), n = 12 0.41a (0.13), n = 96 <.001 DSD sacrum > DSD L4 38 (55.1%), n = 69 4 (28.6%) 1 (5.6%) 5 (5.0%) <.001 Herniation of nerve root sleeves Present in ≥1 level (No.) (%) 53 (72.6%) 10 (71.4%) 2 (11.1%) 1 (1%) <.001 Present in level L5 9 (12.3%) 0 (0%) 0 (0%) 0 (0%) <.001 Present in level S1 35 (47.9%) 8 (57.1%) 2 (11.1%) 0 (0%) <.001 Present in level S2 48 (65.8%) 8 (57.1%) 1 (5.6%) 1 (1%) <.001 Present in level S3 30 (41.1%) 5 (35.7%) 0 (0%) 0 (0%) <.001 Present in level S4 8 (11%) 1 (7.1%) 0 (0%) 0 (0%) <.004 Odds ratio, ≥1 herniation of the nerve root sleeve 265 (34–2029) 250 (25–2458) 12.5 (1–145) ref <.001 Anterior meningocele 27 (37%) 2 (14%) 0 0 <.001 Scalloping L1-S1 ≥1 level 44 (61.1 %), n = 72 8 (42.9%) 1 (5.6%) 4 (4%), n = 100 <.001 Perineural cysts 11 (15.1 %) 1 (7.1%) 1 (5.6%) 8 (7.9%) .387 Disk herniation beneath T12 5 (7%), n = 69 1 (7%) 2 (11%) 6 (6%) .890 Caudal end of dural sac L5, L5/S1, S1 10 (14.5%) 0 (0%) 9 (50%) 22 (21.8%) <.001 S2 26 (37.7%) 9 (64.3%) 8 (44.4%) 68 (67.3%) <.001 S3, S4, S5 33 (47.8%), n = 69 5 (35.7%) 1 (5.6%) 11 (10.9%) <.001 -
Note:—DE, dural ectasia; DSR, dural sac ratio; DSD, dural sac diameter.
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* Study groups not containing similar letters (a, b, c, or d) for means were statistically different at the 5% level. Where n is specified in a cell, there were some observations missing and n is the actual number of observations. Missing values are due to incomplete anatomic coverage with CT, extreme scoliosis at MR, or the dural sac ending above the missed level.
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Criteria Fulfilling Ghent (No.) (%) Independent of DE (n = 73) Dependent on DE (n = 14) Suspected MFS, Not Fulfilling Ghent (n = 18) Controls (n = 101) 1) Anterior meningocele 27 (37) 2 (140 0% 0% 2) DSD sacrum > DSD L4 38 (52) 4 (29) 1 (6) 5 (5) 3) Herniations of ≥1 nerve root sleeves 53 (73) 10 (71) 2 (11) 1 (1) 4) DSR L5 > 0.48 (Oosterhof et al6) 41 (56) 13 (93) 1 (6) 19 (19) 5) DSR S1 > 0.57 (Oosterhof et al6) 45 (62) 11 (85) 1 (6) 12 (12) Presence of ≥1 of above findings 65 (89) 14 (100) 3 (17) 24 (24) Only DSR L5 > 0.48 and/or S1 > 0.57 4 (5) 4 (29) 1 (6) 18 (18) 6) DSR S1 > 0.59 (current study) 43 (59) 11 (85) 1 (6) 7 (7) Presence of DE replacing criteria 4 and 5 with 6 63 (86) 12 (86) 3 (17) 9 (9) -
Note:—MES indicates Marfan Syndrome.
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* * Expressed as number and percentage.
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