International Consensus Statement on the Radiological Evaluation of Dysraphic Malformations of the Spine and Spinal Cord

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Table 1:

Recommended MR imaging sequences and parameters for the assessment of children with suspected DMSSC

Sequence	Plane	Imaging Parameters	Notes
Essential sequences
3 plane scout/localizer	Axial, sagittal, coronal		For subsequent planning
T1-weighted TSE whole spine	Sagittal	3.0 mm thickness (TR, 600 ms, TE, 30 ms)	—
T2-weighted TSE whole spine	Sagittal	3.0 mm thickness (TR, 3000 ms, TE, 120 ms)	—
T2-weighted FS, Dixon, or STIR	Coronal	3.0 mm thickness (TR, 3000 ms, TE, 40 ms)	FS preferred over STIR; whole spine
T1-weighted TSE	Axial	≤3.0 mm thickness	Lumbosacral region (conus and filum terminale) and the suspected area of abnormality (group of axial images through the disc level not applied)
T2-weighted DRIVE, CISS, or FIESTA	Sagittal	0.6 mm thickness	Sagittal acquisition centered on the area of suspected abnormality with 3D reconstructions
Optional sequences
T2-weighted TSE	Axial	3.0 mm thickness, non-fat-suppressed	Suspected area of abnormality (group of axial images through the disc level not applied)
T1-weighted TSE	Coronal	3.0 mm thickness	Centered onto and along the major axis of the sacrum (for suspected sacral abnormalities)
T1-weighted FS	Sagittal	3.0 mm thickness	Confirmation of lipoma
T1-weighted FS C+	Axial, sagittal, coronal	3.0 mm thickness	Suspected infections/tumors
DWI	Axial or sagittal	3.0–4.0 mm thickness	Suspected dysontogenic abnormalities, epidermoids, dermoids, abscesses
T2-weighted GRE or EPI-GRE	Axial	3.0 mm thickness	Evaluation of bony septum in diastematomyelia
T1-weighted TSE C+	Axial, sagittal, coronal	3.0 mm thickness	Suspected mass lesions, dysontogenic abnormalities, or infections

Table 2:

Recommended MR imaging sequences and parameters for the assessment of fetuses with suspected DMSSC

Sequence	Plane	Imaging Parameters	Notes
Essential sequences
3 plane scout/localizer	Axial, sagittal, coronal	—	For subsequent planning
T2-weighted TSE maternal pelvis	Sagittal	—	To assess the position of the fetus; reposition the coil if the fetal ROI is not in the center of the coil
T2-weighted SSFSE or HASTE	Axial, sagittal, coronal^a	3-4 mm thickness, no intersection gaps (TR, 2000–3000 ms, TE, 150 ms), FOV 340 mm, flip angle 160°	Provides excellent anatomic detail
T2-weighted EPI-GRE or true FISP	Axial, sagittal, coronal^a	4 mm thickness, no intersection gap (TR, 4.22 ms, TE, 1.75 ms), FOV 380 mm, flip angle 65°	Evaluation of bony and vascular structures
Optional sequences
T1-weighted SPGR	Sagittal, coronal	5 mm thickness, no intersection gaps (TR, 600 ms, TE, 30 ms), FOV 340 mm	Improves spatial resolution with increasing gestational age
Cine imaging	Volumetric acquisition	—	Assesses fetal extremity mobility

Note:—SPGR indicates spoiled gradient recalled‐echo.
a Acquisition of all 3 planes in T2‐weighted SSFSE (HASTE) and T2‐weighted true FISP may not be feasible if the fetus is moving excessively; and in such a scenario, the protocol can be curtailed with T2‐weighted SSFSE in axial and coronal planes (providing anatomic detail) and T2‐weighted true FISP in sagittal plane (providing assessment of osseous structures).