Sacrum Ultrasonography: An Accurate Alternative to Radiography for Measuring Sacral Ratio in Infants

Abstract

Introduction The aim of this study was to compare the compliance of sacrum ultrasonography with radiography for the measuring of sacral ratio in infants.

Materials and Methods A total of 129 infants under the age of 6 months, who were a candidate for abdominal and/or pelvic radiographs, were assessed. Sacrum ultrasonography and radiography were performed by a single radiologist using the same device. The sacral ratio was calculated for all patients undergoing ultrasonography and radiography. Agreement between two methods was calculated by Bland-Altman's chart.

Results The mean of sacral ratio was 0.70 ± 0.11 radiographically and 0.72 ± 0.05 ultrasonographically. Based on Bland-Altman's chart, the mean difference between ultrasonography and radiology was 4.6 mm (confidence intervals of 8.18 ± 5.6).

Conclusion Sacrum ultrasonography could be safely used in the investigation of sacral ratio to detect sacrum abnormalities in infants.

Keywords

sacral ratio - sacrum ultrasonography - radiography

Publication History

Received: 21 April 2020

Accepted: 16 August 2020

Article published online:
07 October 2020

• References

• 1 Peña A. Anorectal malformations. Semin Pediatr Surg 1995; 4 (01) 35-47
• 2 Kajbafzadeh AM, Espandar L. New insight in persistent nocturnal enuresis; an abnormal sacral ratio and uroflowmetry: a preliminary report. Internet J Urol 2001; 5 (Suppl. 01) 87
• 3 Levitt MA, Patel M, Rodriguez G, Gaylin DS, Peña A. The tethered spinal cord in patients with anorectal malformations. J Pediatr Surg 1997; 32 (03) 462-468
• 4 Ravichandran D, Shanthi KC, Shankar K, Chandra H. A study on sacral index in Tamil Nadu and Andhra Pradesh population of southern India. J Clin Diagn Res 2013; 7 (09) 1833-1834
• 5 Warne SA, Godley ML, Owens CM, Wilcox DT. The validity of sacral ratios to identify sacral abnormalities. BJU Int 2003; 91 (06) 540-544
• 6 Williamson D, Watura R, Cobby M. Ultrasound imaging of forearm fractures in children: a viable alternative?. J Accid Emerg Med 2000; 17 (01) 22-24
• 7 Yadav N, Saini K, Patil K. Determination of sex using dry adult human sacrum-a morphometric study. Int J Curr Res Rev 2015; 7 (03) 22
• 8 Coley BD, Murakami JW, Koch BL, Shiels II WE, Bates G, Hogan M. Diagnostic and interventional ultrasound of the pediatric spine. Pediatr Radiol 2001; 31 (11) 775-785
• 9 Dick EA, Patel K, Owens CM, De Bruyn R. Spinal ultrasound in infants. Br J Radiol 2002; 75 (892) 384-392
• 10 Davidoff AM, Thompson CV, Grimm JM, Shorter NA, Filston HC, Oakes WJ. Occult spinal dysraphism in patients with anal agenesis. J Pediatr Surg 1991; 26 (08) 1001-1005
• 11 Macedo M, Martins JL, Freitas Filho LG. Sacral ratio and fecal continence in children with anorectal malformations. BJU Int 2004; 94 (06) 893-894
• 12 Ambroggio L, Sucharew H, Rattan MS. et al. Lung ultrasonography: a viable alternative to chest radiography in children with suspected pneumonia?. J Pediatr 2016; 176: 93-98.e7
• 13 Zieger M, Dörr U, Schulz RD. Pediatric spinal sonography. Part II: Malformations and mass lesions. Pediatr Radiol 1988; 18 (02) 105-111