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Purpose <p>To investigate the correlation between tethered cord syndrome (TCS) and lumbosacral plexus (LSP) abnormalities in preschool children and evaluate the diagnostic utility of multiparametric MRI (mpMRI).</p> Methods <p>A total of 100 preschool children (mean age 1.72 ± 1.94 years) with suspected or confirmed TCS were enrolled between October and December 2024. All participants underwent mpMRI, including supine sagittal T2WI-FS, T1WI, axial T2WI-FS/T1WI, coronal 3D Cube STIR (for LSP visualization), and prone thin-layer T2WI-SSFSE (for FT motility assessment). Two senior radiologists independently evaluated spinal cord conus position, FT motility, FT thickness, and LSP abnormalities. Statistical analyses included intraclass correlation coefficient (ICC), receiver operating characteristic (ROC) curves, and Chi-square tests.</p> Results <p>No LSP morphological abnormalities were observed in all cases (84 non-surgical, 16 postoperative), ruling out LSP’s role in early TCS. FT motility (AUC = 0.81, ICC = 0.82) and FT thickness (AUC = 0.83, ICC = 0.96) were reliable TCS predictors (both <i>P</i> &lt; 0.001), while LSP metrics were non-diagnostic (AUC = 0.50 – 0.52, <i>P</i> &gt; 0.05). Postoperatively, 6.25% (1/16) experienced complications (e.g., CSF leakage), while 18.8% (3/16) exhibited imaging artifacts from tissue edema.</p> Conclusion <p>TCS in preschool children does not correlate with LSP morphological abnormalities. Preschool TCS pathology is confined to the spinal cord/FT, with no LSP involvement. FT metrics are core diagnostic markers, and routine LSP MRI is unnecessary—avoiding prolonged scans/anesthesia risks in young children.</p> Trial registration <p>Chinese Clinical Trial Registry (ChiCTR), ChiCTR2500098818; prospectively registered on 13 March 2025.</p>

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Absence of lumbosacral plexus abnormalities in preschool children with tethered cord syndrome: A multiparametric MRI study

  • 期刊论文

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  • 发表日期：

    2026年3月10日

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  • Shengwei Xu,
  • Shilong Tang,
  • Wushuang Chen,
  • Junya Ma,
  • Xiao Fan,
  • Ling He,
  • Faqi Li

摘要

Purpose

To investigate the correlation between tethered cord syndrome (TCS) and lumbosacral plexus (LSP) abnormalities in preschool children and evaluate the diagnostic utility of multiparametric MRI (mpMRI).

Methods

A total of 100 preschool children (mean age 1.72 ± 1.94 years) with suspected or confirmed TCS were enrolled between October and December 2024. All participants underwent mpMRI, including supine sagittal T2WI-FS, T1WI, axial T2WI-FS/T1WI, coronal 3D Cube STIR (for LSP visualization), and prone thin-layer T2WI-SSFSE (for FT motility assessment). Two senior radiologists independently evaluated spinal cord conus position, FT motility, FT thickness, and LSP abnormalities. Statistical analyses included intraclass correlation coefficient (ICC), receiver operating characteristic (ROC) curves, and Chi-square tests.

Results

No LSP morphological abnormalities were observed in all cases (84 non-surgical, 16 postoperative), ruling out LSP’s role in early TCS. FT motility (AUC = 0.81, ICC = 0.82) and FT thickness (AUC = 0.83, ICC = 0.96) were reliable TCS predictors (both P < 0.001), while LSP metrics were non-diagnostic (AUC = 0.50 – 0.52, P > 0.05). Postoperatively, 6.25% (1/16) experienced complications (e.g., CSF leakage), while 18.8% (3/16) exhibited imaging artifacts from tissue edema.

Conclusion

TCS in preschool children does not correlate with LSP morphological abnormalities. Preschool TCS pathology is confined to the spinal cord/FT, with no LSP involvement. FT metrics are core diagnostic markers, and routine LSP MRI is unnecessary—avoiding prolonged scans/anesthesia risks in young children.

Trial registration

Chinese Clinical Trial Registry (ChiCTR), ChiCTR2500098818; prospectively registered on 13 March 2025.