Diffusion Weighted Imaging of the spinal cord in children after a prenatal myelomeningocele repair

Diffusion Weighted Imaging of the spinal cord in children after a prenatal myelomeningocele repair | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Diffusion Weighted Imaging of the spinal cord in children after a prenatal myelomeningocele repair romain corroenne, Thierry AGM Huisman, william whitehead, ahmed nassr, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7495159/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Mar, 2026 Read the published version in Pediatric Radiology → Version 1 posted 15 You are reading this latest preprint version Abstract Background Little is known about the impact of spinal cord microstructural alterations after prenatal myelomeningocele (MMC) repair and their association with neurological outcomes. Objective To assess spinal cord diffusivity using diffusion-weighted imaging (DWI) at 12 months of age in children who underwent prenatal MMC repair and to explore associations with clinical outcomes. Materials and Methods This retrospective cohort study included children who underwent prenatal MMC repair at XXXX between November 2011 and May 2023. All children met MOMS trial inclusion criteria. DWI was performed at approximately 12 months of age, and apparent diffusion coefficient (ADC) metrics were obtained at the level of the spinal lesion. Neurological outcomes included intact S1 motor and sensory level, need for anticholinergic therapy or clean intermittent catheterization at 12 months, and ambulatory status at 30 months. Associations between ADC (expressed as 10⁻⁶ mm²/s) and outcomes were assessed using the Mann-Whitney U test. Results Thirty-six children were included (23 fetoscopic, 13 open-hysterotomy repairs). ADC was significantly higher in children with intact S1 motor function (1.251 [1.001–1.891] vs. 1.193 [1.001-1.300], p = 0.01), intact S1 sensory level (1.362 [1.120–1.740] vs. 1.212 [1.041–1.378], p = 0.02), no anticholinergic therapy (1.315 [1.130–1.697] vs. 1.223 [1.041-1.400], p = 0.04), no catheterization (1.327 [1.041–1.739] vs. 1.212 [1.120–1.319], p = 0.04), and ambulatory status at 30 months (1.362 [1.041–1.891] vs. 1.187 [1.001–1.456], p = 0.02). Conclusion Lower ADC values at the lesion level were associated with adverse neurological and urological outcomes in children after prenatal MMC repair, suggesting that DWI may provide early imaging biomarkers of spinal cord integrity. Figures Figure 1 Figure 2 Figure 3 Introduction Myelomeningocele (MMC) results from failed closure of the caudal neural tube during the fourth week of pregnancy [ 1 ] and leads to motor, sensory and sphincter [ 2 – 7 ]. According to the “two-hit” hypothesis [ 8 ], neurological impairment stems from both primary neurulation failure [ 9 ] and secondary damage from prolonged exposure of the neural tissue to amniotic fluid and mechanical trauma [ 2 , 3 , 6 , 10 , 11 ]. Incomplete neural tube closure disrupts cerebrospinal fluid (CSF) circulation and prevent ventricular expansion, contributing to migrational abnormalities and hindbrain herniation [ 9 ]. This condition increases intracranaial pressure, reduces cerebral perfusion, and causes demyelination and axonal loss. In parallel, exposed spinal cord show cytoarchitectural disruption and progressive motor neuron loss [ 12 ]. The MOMS trial demonstrated that prenatal MMC repair improves motor outcomes and reduces hydrocephalus rates compared to postnatal repair [ 13 ]. However, prenatal repair is not a cure and children who have had in-utero repair may still have significant neurological disability, including an 18% rate of being non-ambulatory and a 62% rate of needing clean intermittent bladder catheterization (CIC) [ 14 , 15 ]. Predicting long-term outcomes remains challenging. Diffusion weighted imaging (DWI) provides quantitative assessment of tissue diffusivity by measuring the apparent diffusion coefficient (ADC) of water molecules [ 16 ]. ADC values reflect cellular integrity and density [ 17 ]. Within the spinal cord, white matter tracts are highly organized, making DWI a relevant technique to assess axonal architecture [ 18 ]. While spinal DWI has been applied in neoplastic, ischemic, and traumatic settings, its role in evaluating post-repair MMC spinal diffusivity has not been studied [ 18 – 24 ]. We hypothesized that children with prenatally repaired MMC will have microstructural changes in the spinal cord, detectable on DWI and that these changes may correlate with their neurological outcomes. The objectives of this study were (1) to evaluate spinal cord diffusivity using DWI at 12 months in children who had a prenatal MMC repair, and (2) to evaluate the association between spinal ADC values and neurological outcomes including motor, sensory, bladder and ambulatory outcomes. Materials and methods - Study population This retrospective study included children who underwent prenatal MMC repair (fetoscopic or open-hysterotomy repair) at the XXXX between November 2011 and May 2023. All cases met MOMS trial inclusion and exclusion criteria [ 13 ], except for maternal BMI (up to 40 kg/m²). Exclusion criteria were: absence of spinal DWI at 12-month MRI, age 30 months at imaging, missing follow-up, or consent withdrawal. Oversight was provided by the FDA (#G140201), the XXXXXX Institutional Review Board (IRB) (H-34680 and H-43359), the XXXX Fetal Therapy Board, and a Data Safety Monitoring Board. The protocol is registered on the ClinicalTrials.gov (XXX and XXX). All women provided written informed consent. Retrospective data from patients undergoing open-hysterotomy repair was obtained under the IRB approved protocol H-38479. All surgeries and preoperative imaging scans were performed before 26w0d. - Prenatal evaluation Fetal MRI (1.5-T Philips Ingenia) was performed before surgery to assess the level of hindbrain herniation and classify lesions as myelomeningocele or myeloschisis [ 25 ]. Ultrasound (GE Voluson E8/E10, GE Healthcare, Milwaukee, WI, USA) was used to define lesion level by the uppermost bony defect [ 26 ]. - Prenatal surgery Patients who underwent prenatal MMC repair were managed per our standard protocol in terms of steroid administration, prophylactic tocolysis (preoperative indomethacin or nifedipine and intra- and post-operative magnesium sulfate) and prophylactic antibiotics (cefazolin -if allergic, clindamycin- and metronidazole and azithromycin) [ 27 ]. The fetoscopic technique evolved since the first case we performed in 2014. We have recently described the evolution of the technique and the associated outcomes [ 28 ] (Supplementary material). The open hysterotomy repair technique was performed using the same technique as reported in the MOMS trial [ 13 ]. The decision regarding the type of prenatal repair used was left to maternal choice after extensive counseling with full understanding of the experimental nature of the fetoscopic repair. - Post-operative imaging and delivery Six weeks following surgery, a second fetal MRI was performed using the same protocol as before surgery. Complete reversal of hindbrain herniation was defined when the cerebellar tonsils were seen above the level of the foramen magnum. Delivery occurred via induction or planned cesarean at 39–40 weeks for fetoscopic cases [ 29 , 30 ] and by cesarean before 37 weeks for open-hysterotomy cases. - Neurological outcomes All postnatal evaluations were performed unblinded, as clinicians were aware of the type of intervention received. Cases were carefully evaluated overtime to assess the need for hydrocephalus treatment. Need for hydrocephalus treatment was determined following revised criteria by Tulipan et al [ 31 ] and included: clinical signs of increased pressure (split suture, bulging fontanelle or sunsetting eyes, increasing head cephalic diameter) and enlarged ventricles. In case of hydrocephalus, either a ventriculoperitoneal shunt or an endoscopic third ventriculostomy with choroid plexus cauterization was performed. When both VP shunt and Endoscopic Third Ventriculostomy and choroid Plexus Cauterization were viable options, the primary caregiver made the treatment decision. The need for spinal cord detethering was also recorded. Children were evaluated at 12 months for motor and sensory levels by a pediatrician using the lowest functional myotomes. (Supplementary Table 1) [ 32 ]. Outcomes were dichotomized as “First sacral level (S1)” or not S1 level. We chose S1 as a threshold for favorable outcomes because it represents a critical level of motor function essential for lower limb movement, particularly for activities such as walking [ 33 ]. Urological outcomes were assessed and included the need for anticholinergic treatment and the need for clean intermittent bladder catheterization (CIC). The need for these was determined by a pediatric urologist, consistent with Centers for Disease Control UMPIRE protocol, based on renal ultrasound, voiding cystourethrography, and cystometrogram results [ 34 ]. Treatment was initiated for elevated bladder pressures, vesicoureteral reflux, and/or hydronephrosis. At 30 months of life, the child’s ambulatory skills were assessed by pediatricians and classified as: (1) walking independently (with or without orthotics), (2) walking with assistive devices (i.e. walker) and (3) not walking (using wheelchair/stroller) [ 15 ]. Two groups were created, including independent ambulators (children walking independently with or without orthotics) and non-independent ambulators (walking with assistive devices or not walking). - DWI acquisition All children underwent brain and spine MRI at 12 months on a 1.5-Tesla Philips Ingenia superconducting magnet (Phillips Medical Systems, Best, the Netherlands) or a 1.5-Tesla Siemens Aera (Siemens Healthcare, Erlangen, Germany) using a multi-channel body coil. The standard imaging protocol consisted of multiplanar, single-shot, fast spin-echo T2-weighted imaging, gradient echo T1-weighted imaging, and balanced steady state free precession T2-weighted imaging and axial and sagittal DWI of the brain and the spine respectively. Isotropic diffusion weighted images and ADC maps were automatically generated using a vendor-specific program. The sequences were performed using 3 mm slice thickness, 3 mm slice overlap, 1550ms repetition time and 140ms time to echo, with the following settings: field of view, 280 mm × 280 mm; matrix, 128 × 128; voxel size, 2.5 mm × 2.5 mm × 4.0 mm. Diffusion weighted sequences used a b-value of 0 and 800 mm 2 /s. - DWI analysis (Figure 1) DWI images were anonymized and processed using ITK-SNAP [ 35 ]. Regions-of-interest (ROIs) were manually drawn on ADC maps at two levels: (1) at the anatomical level of the lesion and (2) three levels above(Fig. 1 ). In case of hydromyelia, only spinal tissue excluding CSF was analyzed (Supplementary Fig. 1). Given the limitations of MRI in distinguishing syringomyelia from hydromyelia, the term 'syrinx' was used throughout to describe dilated central canal or parenchymal cavities. Each ROI was measured twice by the same blinded rater (R.C.), and the average value was used. A subset of 12 cases was reviewed by an experienced pediatric neuroradiologist (T.H.) to assess ROI placement reproducibility. All ADC maps were visually inspected for artifacts such as motion, distortion, and signal dropouts. - Statistical analysis Data analysis was performed using the Statistical Package for Social Sciences (SPSS), version 21.0 (IBM Corporation, Armonk, NY, USA). Quantitative variables were expressed as median [interquartile range] if they had a non-normal distribution (assessed by Kolmogorov test) and compared using a Mann-Whitney U test or expressed as mean ± standard deviation if they had a normal distribution and compared using t-test. Pearson’s X 2 or Fisher’s exact tests were used to compare qualitative data respectively. Ordinal regression assessed ADC metrics across ambulation categories. Intra-class correlation coefficient evaluated inter- and intra- rater agreement. ROC curve analysis and Youden index [ 36 ] determined optimal ADC cut-offs for each outcome. Logistic regression models adjusted for lesion level and hydrocephalus assessed associations between ADC and outcomes. A p-value < 0.05 was considered statistically significant. Results - Characteristics of the cohort Out of 197 children who underwent prenatal MMC repair (150 fetoscopic, 47 open-hysterotomy), 36 met inclusion criteria. Exclusions included lack of spinal DWI at 12 months (n=75), age 30 months at scan (n=71), and incomplete follow-up (n=15) (Figure 2). Median gestational age at repair was 24.9 [22.3–25.9] weeks. Of the 36 children, 63.9% were female, 61.1% had cystic lesions, and 80.6% had an anatomical defect below L2. Median gestational age at birth was 37.5 [30.3–40.9] weeks, and 22.2% had clubfeet. At 12 months, 72.2% had intact S1 motor function and 67.7% had intact S1 sensory level. Anticholinergic treatment was required in 30.5% and CIC in 22.2%. At 30 months, 63.9% walked independently. Syrinx was present in 16.7%. Hydrocephalus treatment was required in 25% of the cases during the first year of life. At 30 months of life, 63.9% of children in this cohort were able to walk independently. - Motor function at 12 months of life (Table 1) Children with intact S1 motor function had significantly higher ADC at the lesion level (1.251 [1.001–1.891] ×10⁻⁶ mm²/s) compared to those with worse motor function (1.193 [1.001–1.300], p = 0.01). The best ADC cut-off to predict intact S1 motor level was 1.305 ×10⁻⁶ mm²/s (Table 2). After adjusting for lesion level and hydrocephalus, this threshold was associated with 11.1-fold higher odds of achieving S1 motor function. No difference was observed in ADC values measured 3 levels above the lesion (Table 1) - Sensory level at 12 months of life (Table 3) Children with intact S1 sensory level had higher lesion-level ADC (1.362 [1.120–1.740]) than those with worse sensory function (1.212 [1.041–1.378], p = 0.02). An ADC cut-off of 1.314 ×10⁻⁶ mm²/s predicted intact S1 sensory level (aOR 15.9, adjusted for lesion level and hydrocephalus) (Table 2). ADC values above the lesion were not significantly different between groups (Table 3). - Urological outcomes at 12 months of life (Table 4) Children requiring anticholinergics had lower ADC at the lesion (1.223 [1.041–1.400]) compared to those who did not (1.315 [1.130–1.739], p = 0.04). Similarly, those requiring CIC had lower ADC (1.212 [1.120–1.319]) versus those who did not (1.327 [1.041–1.739], p = 0.04). ADC thresholds predicting absence of urological dysfunction were (Table 2): · Anticholinergic treatment: 1.305 ×10⁻⁶ mm²/s (not needing treatment if above threshold) · CIC: 1.336 ×10⁻⁶ mm²/s. Children who had an ADC value at the level of the lesion above 1.336 x10 -6 mm²/s had 9.93 more chances of not requiring CIC compared to cases with ADC value lower than this cut off, after adjusting by the anatomical level of lesion and the need for hydrocephalus treatment (Table 2). No significant differences were found in ADC measured above the lesion (Table 4). Ambulation at 30 months of life (Table 5) Independent walkers had higher lesion-level ADC (1.362 [1.041–1.891]) than non-independent walkers (1.187 [1.001–1.456], p = 0.02). ADC metrics at the lesion level were significantly higher in children able to walk independently (1.362 [1.041-1.891] x10 -6 mm²/s) as compared to children who required assistive devices to walk (1.217[1.148-1.319] x10 -6 mm²/s) and those who were not ambulatory (1.141[1.101-1.456] x10 -6 mm²/s, p = 0.03) (Figure 3). At the level of lesion, ADC equal to 1.336 x10 -6 mm²/s was the best cut-off to predict independent ambulation. Children who had an ADC value at the level of the lesion of above 1.336 x10 -6 mm²/s had 17.47 more chances of being an independent ambulator compared to cases with ADC value lower than this cut off after adjusting on the anatomical level of lesion and the need for hydrocephalus treatment (Table 2). There were no significant differences in ADC metrics assessed at 3 levels above the lesion (Table 5). Discussion Our results suggest that spinal cord diffusivity can be reliably evaluated using DWI in children following prenatal MMC repair, and that ADC metrics are associated with neurological outcomes. Children with better outcomes (S1 motor/sensory level, independent ambulation, no need for anticholinergics or CIC) showed higher ADC values at the lesion level compared to children with worse neurological outcomes. These findings are aligned with prior reports that show how despite having an in-utero repair, MMC is associated with significant long term neurological morbidity including motor and sensory deficits and sphincter dysfunction [ 2 – 7 ]. In our study, 72% of children had intact S1 MF at 12 months of age, 64% were able to walk independently, 30% had urological dysfunction requiring CIC and 22% needed anticholinergic medication. The spinal cord in MMC is injured through both primary (neurulation failure) and secondary (mechanical, chemical) mechanisms [ 2 , 3 , 5 , 6 , 10 , 11 , 37 ]. The open neural tube leads to CSF leakage, hindbrain herniation, and increased intracranial pressure, with subsequent hypoperfusion and demyelination. Exposure of the spinal tissue to amniotic fluid contributes to motor neuron loss, particularly at and below the lesion [ 12 ]. Our findings confirm that diffusivity changes are most pronounced at the lesion level, with no significant changes three levels above. Several studies have reported significant histological alterations in the spinal cord in patients with MMC. Hutchins et al reported a range of 20–100% tissue loss in the spinal cords of fetuses with MMC [ 38 ]. Sival et al , reported a reduced number and abnormal positioning in lower motor neurons, aberrant spinal blood vessels and abnormalities of the central canal [ 39 ]. In all cases, spinal integrity was better preserved in the cranial rather than the caudal direction relative to the neural tube defect. Ben Miled et al , demonstrated significant neuronal loss in the spinal cord in fetuses with MMC who underwent termination of pregnancy [ 12 ]. They reported early, severe and progressive loss of motor neurons, especially at the level of the exposed spinal cord, but also above the lesion to a much lesser degree. We demonstrated that the most significant microstructural changes were at the level of the defect but not at higher levels above the lesion. By ensuring a watertight repair at midgestation and by reversing the hindbrain herniation, it is hypothesized that prenatal repair protects the spinal cord (and limits the progression of ongoing injury), either by reducing the exposure of the neural elements to the amniotic fluid, or by reducing the compression of the brainstem and spinal cord caused by hindbrain herniation [ 40 ]. DWI appears to add indirect information to our armamentarium regarding central nervous system microstructure, over and above what can be obtained using conventional MRI [ 16 , 41 ]. Previous reports have shown how DWI is able to detect differences in the cellularity of the spinal cord in lesions such as acute spinal cord ischemia, spinal cord tumors, anterior spinal artery infarction, myelitis and lesions associated with multiple sclerosis [ 23 , 42 ]. We believe that our study is the first to document the spinal cord diffusivity with DWI after prenatal MMC repair. We conclude that children with adverse neurological outcomes present with reduced ADC metrics. The observed decrease in ADC metrics may be associated with, or indicate, an absolute decrease (or loss) of motor neurons and/or the fibrous remodeling of the spinal cord secondary to the primary injury rather than due to the prenatal MMC repair. Fibrotic scar formation after a spinal cord injury includes the migration, proliferation and extracellular matrix deposition of fibroblasts. The fibrotic scar is thought to maintain tissue integrity and limit inflammation after spinal cord injury [ 43 ]. During scar formation, the complex assembly of collagen fibers, proteoglycan, astrocytes and microglia create a physical barrier to water movement that can reduce ADC metrics [ 43 , 44 ]. However, there is no available histological data to confirm this hypothesis. Our findings indicate that reduced ADC may reflect increased cellular density or gliotic tissue, rather than simply loss of neurons. Since most MMC patients have neurogenic bladder dysfunction with an ensuing increased risk for renal impairment [ 45 ], it is important to identify those at greatest risk for this complication. Neurologic control of the bladder [ 46 ] is a complex process involving central (pontine) control of the synchronization between bladder contraction and relaxation of the internal urethral sphincter during voiding. Innervation of the bladder includes parasympathetic fibers (primary innervation) arising from the S2-S4 cord segments, sympathetic fibers (bladder motor activity) arising from T11-L3, and somatic fibers arising from S2-S4 (external urethral sphincter). This multifactorial system makes the prediction of urological outcomes in patients with MMC very difficult even after a successful prenatal repair. Our findings show that children who required anticholinergics or CIC had significantly lower ADC values, indicating a potential association between spinal cord microstructure and autonomic function. Our findings suggest that early identification of microstructural spinal abnormalities using DWI could help anticipate urological management needs. The potential to predict outcomes as early as 12 months using spinal DWI could assist clinicians and families in long-term care planning. However, the value of in utero DWI remains unexplored. Although current fetal MRI protocols do not include DWI of the spine, future studies should assess whether such imaging could offer earlier prognostic information. Although DWI methodology is well established, inter and intra observed variability studies were performed showing excellent correlation and reliability. One of the main strengths of this study is its novelty and potential future applications as a prognostic biomarker in this complex condition. In addition, all assessments were performed in a single center by a consistent multidisciplinary team limiting variability in data collection and outcome categorization. Some limitations must be acknowledged. Not all eligible children had DWI sequences at 12 months, which limited sample size. Evaluators were not blinded to surgical history, potentially introducing bias. DWI of the spine is technically challenging due to motion artifacts, low resolution, and poor signal-to-noise ratio. Use of two different MRI systems may have affected ADC comparability. Differentiating white and gray matter was difficult due to small cord dimensions. Lastly, variations in surgical technique over the study period may have influenced outcomes, and no morphological spinal features were assessed. Conclusions This study suggests a significant association between spinal cord diffusivity and neurological outcomes in children with MMC who have undergone an in utero repair. Children with intact MF, S1 sensory level, who are able to walk independently, and who did not require anticholinergic or CIC therapies, demonstrated significantly higher ADC metrics in the spinal cord at the level of the lesion as compared to children with worse neurological outcomes. Declarations Funding: This research received no external funding. Author Contribution Conceptualisation & writing (RC, MSC), Data curation (WW, AN, CB), Resources (JM, JC, HC), Formal analysis (RC), Investigation (RJ), Methodology (TH, MSC), Supervision (MB, MSC), review (all co-authors), validation (all co-authors) Acknowledgement: none Data Availability Data supporting the findings of this study are available from the corresponding author upon reasonable request. References Avagliano L, Massa V, George TM et al (2019) Overview on neural tube defects: From development to physical characteristics. Birth Defects Res 111:1455–1467 Bowman RM, McLone DG, Grant JA et al (2001) Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg 34:114–120. https://doi.org/10.1159/000056005 Shin M, Kucik JE, Siffel C et al (2012) Improved Survival Among Children with Spina Bifida in the United States. 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Pediatr Pathol Lab Med 16:701–712 Sival DA, Verbeek RJ, Brouwer OF et al (2008) Spinal hemorrhages are associated with early neonatal motor function loss in human spina bifida aperta. Early Hum Dev 84:423–431. https://doi.org/10.1016/J.EARLHUMDEV.2007.11.003 McLone DG, Dias MS (2003) The Chiari II malformation: cause and impact. Child’s Nerv Syst 19:540–550. https://doi.org/10.1007/s00381-003-0792-3 Bihan DL (2013) Apparent diffusion coefficient and beyond: What diffusion mr imaging can tell us about tissue structure. Radiology 268:318–322 Moseley ME, Cohen Y, Mintorovitch J et al (1990) Early detection of regional cerebral ischemia in cats: comparison of diffusion- and T2-weighted MRI and spectroscopy. Magn Reson Med 14:330–346. https://doi.org/10.1002/MRM.1910140218 Li Z, Yu S, Hu X et al (2021) Fibrotic Scar After Spinal Cord Injury: Crosstalk With Other Cells, Cellular Origin, Function, and Mechanism. Front Cell Neurosci 15:720938. https://doi.org/10.3389/FNCEL.2021.720938 Soderblom C, Luo X, Blumenthal E et al (2013) Perivascular Fibroblasts Form the Fibrotic Scar after Contusive Spinal Cord Injury. J Neurosci 33:13882–13887. https://doi.org/10.1523/JNEUROSCI.2524-13.2013 Wiener JS, Suson KD, Castillo J et al (2018) Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015. J Urol 200:187–194. https://doi.org/10.1016/J.JURO.2018.02.3101 Amarante MA, Shrensel JA, Tomei KL et al (2012) Management of urological dysfunction in pediatric patients with spinal dysraphism: review of the literature. Neurosurg Focus 33. https://doi.org/10.3171/2012.7.FOCUS12232 Tables Table 1. Motor function at 12 months of age Intact motor function -S1 MF- (n=26) Non S1 motor function (n=10) p ADC at the level of lesion (x10 -6 mm²/s) 1.251[1.001-1.891] 1.193[1.001-1.300] 0.01 ADC 3 levels above the lesion (x10 -6 mm²/s) 1.247[0.697-2.078] 1.363[1.178-2.078] 0.54 Age at MF assessment (months) 12[7-18] 12[11-19] 0.88 Age at DWI-MRI scan (months) 12[11-21] 15[12-21.7] 0.47 Area of the ROI obtained at the level of lesion (mm²) 7.7[3.1-60] 6.8[4-9] 0.72 Area of the ROI obtained 3 levels above the lesion (mm²) 6[4-20] 6.5[4-9] 0.49 Children’s gender (male, %) 18/26(69.2) 5/10(50) 0.28 Anatomical level of lesion below L2 (%) 22/26(84.6) 7/10(70) 0.31 Type of lesion (cystic-MMC)(%) 14/26(53.8) 8/10(80) 0.15 At least one club foot at birth (%) 3/26(11.5) 5/10(50) 0.01 Hydrocephalus treatment during the first year of life (%) 6/26(23.1) 3/10(30) 0.67 Type of fetal repair (fetoscopic, %) 15/26(57.7) 8/10(80) 0.21 Reversal of Chiari II malformation as observed 6 weeks post fetal surgery (%) 24/26(92.3) 9/10(90) 1 Data are expressed as n(%) or median[range]. Abbreviations: S1, sacral one; ADC, Apparent Diffusion Coefficient ; MF: motor function;DWI, Diffusion Weighted Imaging ; ROI, region of interest ; L2, lumbar two level; MMC, myelomeningocele Table 2. Best ADC cut-off measured at the level of lesion to predict neurological outcomes Abbreviations: ADC, Apparent Diffusion Coefficient ; AUC, area under curve; Se, Sensitivity; Sp, Specificity; aOR, adjusted odds ratio; CI95%, 95% confidence interval; S1, sacral one level; CIC, clean intermittent catheterization 1.Best ADC cut-off to predict neurological outcomes with the best sensitivity and specificity was determined by ROC curve analysis and Youden test. ADC is expressed in mm/s². 2. Adjusted by the level of lesion and the need for hydrocephalus treatment Table 3. Sensory level at 12 months of age S1 sensory level (n=21) Not S1 sensory level (n=10) p ADC level of lesion (x10 -6 mm²/s) 1.362[1.120-1.740] 1.212[1.041-1.378] 0.02 ADC 3 levels above the lesion (x10 -6 mm²/s) 1.223[0.698-2.078] 1.352[1.179-1.719] 0.50 Age at sensory testing (months) 12[7-28] 12[11-19] 0.98 Age at DWI-MRI scan (months) 12[11-18] 12[12-21.5] 0.40 Area of the ROI obtained at the level of lesion (mm²) 8.8[3.1-60] 5.1[4.2-6.1] 0.33 Area of the ROI obtained 3 levels above the lesion (mm²) 6.1[4-11.1] 5.9[3.8-20] 0.64 Children’s gender (male, %) 9/21(42.9) 2/9(22.2) 0.28 Anatomical level of lesion below L2 (%) 15/21(71.4) 8/9(88.9) 0.30 Type of lesion (cystic-MMC)(%) 12/21(57.1) 5/9(55.6) 0.94 At least one club foot at birth (%) 4/21(19) 2/9(22.2) 1 Hydrocephalus treatment during the first year of life (%) 7/21(33.3) 2/9(22.2) 0.54 Type of fetal repair (fetoscopic, %) 12/21(57.1) 7/9(77.8) 0.28 Reversal of Chiari II malformation as observed 6 weeks post fetal surgery (%) 19/21(90.5) 9/9(100) 1 Data are expressed as n (%) or median [range]. Abbreviations: S1, sacral one; ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele Table 4. Urological outcomes at 12 months of age Need anticholinergic treatment (n=10) No need for anticholinergic treatment (n=26) p a Need clean intermittent catheterization (n=9) No clean intermittent catheterization (n=27) P b ADC level of lesion (x10 -6 mm²/s) 1.223[1.041-1.400] 1.315[1.130-1.739] 0.04 1.212[1.120-1.319] 1.327[1.041-1.739] 0.04 ADC 3 levels above (x10 -6 mm²/s) 1.464[1.180-1.687] 1.219[0.698-2.078] 0.30 1.299[1.185-1.403] 1.247[1.068-1.710] 0.90 Age at urological evaluation (months) 14.5[12-19] 13[7-18] 0.29 14.5[12-19] 13[7-18] 0.29 Age at DWI-MRI (months) 12[11-19] 12[11-24] 0.56 12[12-12.7] 12[11-23.2] 0.67 Area of the ROI obtained at the level of lesion (mm²) 6.8[6.1-8.8] 7[3.1-60] 0.82 6.7[4.2-8.9] 7.9[3.1-60] 0.35 Area of the ROI obtained 3 levels above the lesion (mm²) 5.1[4-20] 5.2[4.2-8] 0.88 6.1[4-20] 6[4.2-9.2] 0.96 Children’s gender (male, %) 6/10(60) 7/26(26.9) 0.06 4/9(44.4) 9/27(33.3) 0.54 Anatomical level of lesion below L2 (%) 8/10(80) 21/26(80.8) 0.96 8/9(88.9) 21/27(77.8) 0.47 Type of lesion (cystic-MMC)(%) 7/10(70) 15/26(57.7) 0.50 6/9(66.7) 16/27(59.3) 0.69 Hydrocephalus treatment during the first year of life (%) 3/10(30) 6/26(23.1) 0.67 2/9(22.2) 7/27(25.9) 0.82 Type of fetal repair (fetoscopic, %) 4/10(40) 19/26(73.1) 0.07 4/9(44.4) 19/27(70.4) 0.16 Reversal of Chiari II malformation as observed 6 weeks post fetal surgery (%) 10/10(100) 23/26(88.5) 0.54 9/9(100) 24/27(88.9) 0.56 Data are expressed as n (%) or median [range]. a. Represents the comparison between anticholinergics vs no anticholinergics b. Represents the comparison between clean intermittent catheterization vs no clean intermittent catheterization Abbreviations: CIC, Clean Intermittent Catheterization; ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele Table 5. Comparison between children able to walk independently and children not walking independently Walking independently (n=23) Non walking independently at 30 months of life (n=13) p ADC level of lesion (x10 -6 mm²/s) 1.362[1.041-1.891] 1.187[1.001-1.456] 0.02 ADC 3 levels above (x10 -6 mm²/s) 1.214[0.933-1.829] 1.352[0.697-2.078] 0.54 Age at ambulation assessment (months) 37[24-74] 38[30-63] 0.60 Age at DWI-MRI scan (months) 12[11-15] 19[11.5-24] 0.27 Area of the ROI obtained at the level of lesion (mm²) 6.2[3.1-60] 7.9[6.7-20] 0.33 Area of the ROI obtained 3 levels above the lesion (mm²) 5.3[4-8] 6.4[4.1-20] 0.52 Children’s gender (male, %) 8/23(34.8) 5/13(38.5) 0.82 Anatomical level of lesion below L2 (%) 19/23(82.6) 10/13(76.9) 0.69 Type of lesion (cystic-MMC)(%) 10/23(43.5) 4/13(30.8) 0.45 At least one club foot at birth (%) 6/23(26.1) 2/13(15.4) 0.46 Hydrocephalus treatment during the first year of life (%) 5/23(21.7) 4/13(30.8) 0.55 Type of fetal repair (fetoscopic, %) 16/23(69.6) 7/13(53.8) 0.35 Detethering surgery required by 30 months (%) 4/23(17.4) 4/13(30.8) 0.35 Reversal of Chiari II malformation as observed 6 weeks post fetal surgery (%) 22/23(95.7) 11/13(84.6) 0.54 Data are expressed as n (%) or median[range]. Abbreviations: ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele Additional Declarations No competing interests reported. Supplementary Files DWIspinesupplementary.docx Cite Share Download PDF Status: Published Journal Publication published 03 Mar, 2026 Read the published version in Pediatric Radiology → Version 1 posted Editorial decision: Revision requested 14 Oct, 2025 Reviews received at journal 28 Sep, 2025 Reviews received at journal 27 Sep, 2025 Reviews received at journal 26 Sep, 2025 Reviewers agreed at journal 25 Sep, 2025 Reviews received at journal 24 Sep, 2025 Reviews received at journal 19 Sep, 2025 Reviewers agreed at journal 05 Sep, 2025 Reviewers agreed at journal 04 Sep, 2025 Reviewers agreed at journal 04 Sep, 2025 Reviewers agreed at journal 03 Sep, 2025 Reviewers invited by journal 02 Sep, 2025 Editor assigned by journal 02 Sep, 2025 Submission checks completed at journal 02 Sep, 2025 First submitted to journal 30 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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1","display":"","copyAsset":false,"role":"figure","size":260912,"visible":true,"origin":"","legend":"\u003cp\u003eApparent Diffusion Coefficient map of the spinal cord in case of a Sacral one anatomical level of lesion. - Region-of-interests were manually drawn on the spinal cord at the anatomical level of lesion (S1) and three levels above (L3).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7495159/v1/89eb86dd66dbbf56f796e065.png"},{"id":90908769,"identity":"bc224512-87dc-459f-8c78-2432ec001b9f","added_by":"auto","created_at":"2025-09-09 13:28:00","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":74047,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of the study.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7495159/v1/18fe55b8197358e94b9a8e51.png"},{"id":90911711,"identity":"69cde66a-6890-4396-afd4-5020cd091fde","added_by":"auto","created_at":"2025-09-09 13:44:00","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":123313,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of Apparent Diffusion Coefficient metrics at the level of the anatomical level of lesion between ambulatory skills. *represents an ordinal regression analysis to compare the Apparent Diffusion Coefficient metrics between infants able to walk independently, infants who walked with assistive devices and those who did not walk.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7495159/v1/62c81f1b01f173e888a53f27.png"},{"id":104250760,"identity":"cf2041b3-aa97-422a-9ca5-4db76f51a0bf","added_by":"auto","created_at":"2026-03-09 16:07:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1694405,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7495159/v1/ba43342e-c6a8-4294-9429-4ea01c7c5536.pdf"},{"id":90910156,"identity":"47a96434-3f59-44bf-a64c-c6370aacd0c8","added_by":"auto","created_at":"2025-09-09 13:36:00","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":181173,"visible":true,"origin":"","legend":"","description":"","filename":"DWIspinesupplementary.docx","url":"https://assets-eu.researchsquare.com/files/rs-7495159/v1/8fb726b61f46640d50b72d00.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Diffusion Weighted Imaging of the spinal cord in children after a prenatal myelomeningocele repair","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMyelomeningocele (MMC) results from failed closure of the caudal neural tube during the fourth week of pregnancy [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and leads to motor, sensory and sphincter [\u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. According to the \u0026ldquo;two-hit\u0026rdquo; hypothesis [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], neurological impairment stems from both primary neurulation failure [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and secondary damage from prolonged exposure of the neural tissue to amniotic fluid and mechanical trauma [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Incomplete neural tube closure disrupts cerebrospinal fluid (CSF) circulation and prevent ventricular expansion, contributing to migrational abnormalities and hindbrain herniation [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This condition increases intracranaial pressure, reduces cerebral perfusion, and causes demyelination and axonal loss. In parallel, exposed spinal cord show cytoarchitectural disruption and progressive motor neuron loss [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe MOMS trial demonstrated that prenatal MMC repair improves motor outcomes and reduces hydrocephalus rates compared to postnatal repair [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. However, prenatal repair is not a cure and children who have had in-utero repair may still have significant neurological disability, including an 18% rate of being non-ambulatory and a 62% rate of needing clean intermittent bladder catheterization (CIC) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Predicting long-term outcomes remains challenging.\u003c/p\u003e\u003cp\u003eDiffusion weighted imaging (DWI) provides quantitative assessment of tissue diffusivity by measuring the apparent diffusion coefficient (ADC) of water molecules [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. ADC values reflect cellular integrity and density [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Within the spinal cord, white matter tracts are highly organized, making DWI a relevant technique to assess axonal architecture [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. While spinal DWI has been applied in neoplastic, ischemic, and traumatic settings, its role in evaluating post-repair MMC spinal diffusivity has not been studied [\u003cspan additionalcitationids=\"CR19 CR20 CR21 CR22 CR23\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWe hypothesized that children with prenatally repaired MMC will have microstructural changes in the spinal cord, detectable on DWI and that these changes may correlate with their neurological outcomes.\u003c/p\u003e\u003cp\u003eThe objectives of this study were (1) to evaluate spinal cord diffusivity using DWI at 12 months in children who had a prenatal MMC repair, and (2) to evaluate the association between spinal ADC values and neurological outcomes including motor, sensory, bladder and ambulatory outcomes.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e- Study population\u003c/h2\u003e\u003cp\u003eThis retrospective study included children who underwent prenatal MMC repair (fetoscopic or open-hysterotomy repair) at the XXXX between November 2011 and May 2023. All cases met MOMS trial inclusion and exclusion criteria [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], except for maternal BMI (up to 40 kg/m\u0026sup2;). Exclusion criteria were: absence of spinal DWI at 12-month MRI, age\u0026thinsp;\u0026lt;\u0026thinsp;12 months or \u0026gt;\u0026thinsp;30 months at imaging, missing follow-up, or consent withdrawal. Oversight was provided by the FDA (#G140201), the XXXXXX Institutional Review Board (IRB) (H-34680 and H-43359), the XXXX Fetal Therapy Board, and a Data Safety Monitoring Board. The protocol is registered on the ClinicalTrials.gov (XXX and XXX). All women provided written informed consent. Retrospective data from patients undergoing open-hysterotomy repair was obtained under the IRB approved protocol H-38479. All surgeries and preoperative imaging scans were performed before 26w0d.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003e- Prenatal evaluation\u003c/h3\u003e\n\u003cp\u003eFetal MRI (1.5-T Philips Ingenia) was performed before surgery to assess the level of hindbrain herniation and classify lesions as myelomeningocele or myeloschisis [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Ultrasound (GE Voluson E8/E10, GE Healthcare, Milwaukee, WI, USA) was used to define lesion level by the uppermost bony defect [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003e- Prenatal surgery\u003c/h3\u003e\n\u003cp\u003ePatients who underwent prenatal MMC repair were managed per our standard protocol in terms of steroid administration, prophylactic tocolysis (preoperative indomethacin or nifedipine and intra- and post-operative magnesium sulfate) and prophylactic antibiotics (cefazolin -if allergic, clindamycin- and metronidazole and azithromycin) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe fetoscopic technique evolved since the first case we performed in 2014. We have recently described the evolution of the technique and the associated outcomes [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] (Supplementary material). The open hysterotomy repair technique was performed using the same technique as reported in the MOMS trial [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The decision regarding the type of prenatal repair used was left to maternal choice after extensive counseling with full understanding of the experimental nature of the fetoscopic repair.\u003c/p\u003e\n\u003ch3\u003e- Post-operative imaging and delivery\u003c/h3\u003e\n\u003cp\u003eSix weeks following surgery, a second fetal MRI was performed using the same protocol as before surgery. Complete reversal of hindbrain herniation was defined when the cerebellar tonsils were seen above the level of the foramen magnum. Delivery occurred via induction or planned cesarean at 39\u0026ndash;40 weeks for fetoscopic cases [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] and by cesarean before 37 weeks for open-hysterotomy cases.\u003c/p\u003e\n\u003ch3\u003e- Neurological outcomes\u003c/h3\u003e\n\u003cp\u003eAll postnatal evaluations were performed unblinded, as clinicians were aware of the type of intervention received. Cases were carefully evaluated overtime to assess the need for hydrocephalus treatment. Need for hydrocephalus treatment was determined following revised criteria by Tulipan et al [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] and included: clinical signs of increased pressure (split suture, bulging fontanelle or sunsetting eyes, increasing head cephalic diameter) and enlarged ventricles. In case of hydrocephalus, either a ventriculoperitoneal shunt or an endoscopic third ventriculostomy with choroid plexus cauterization was performed. When both VP shunt and Endoscopic Third Ventriculostomy and choroid Plexus Cauterization were viable options, the primary caregiver made the treatment decision. The need for spinal cord detethering was also recorded.\u003c/p\u003e\u003cp\u003eChildren were evaluated at 12 months for motor and sensory levels by a pediatrician using the lowest functional myotomes. (Supplementary Table\u0026nbsp;1) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Outcomes were dichotomized as \u0026ldquo;First sacral level (S1)\u0026rdquo; or not S1 level. We chose S1 as a threshold for favorable outcomes because it represents a critical level of motor function essential for lower limb movement, particularly for activities such as walking [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Urological outcomes were assessed and included the need for anticholinergic treatment and the need for clean intermittent bladder catheterization (CIC). The need for these was determined by a pediatric urologist, consistent with Centers for Disease Control UMPIRE protocol, based on renal ultrasound, voiding cystourethrography, and cystometrogram results [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Treatment was initiated for elevated bladder pressures, vesicoureteral reflux, and/or hydronephrosis.\u003c/p\u003e\u003cp\u003eAt 30 months of life, the child\u0026rsquo;s ambulatory skills were assessed by pediatricians and classified as: (1) walking independently (with or without orthotics), (2) walking with assistive devices (i.e. walker) and (3) not walking (using wheelchair/stroller) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Two groups were created, including independent ambulators (children walking independently with or without orthotics) and non-independent ambulators (walking with assistive devices or not walking).\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e- DWI acquisition\u003c/h2\u003e\u003cp\u003eAll children underwent brain and spine MRI at 12 months on a 1.5-Tesla Philips Ingenia superconducting magnet (Phillips Medical Systems, Best, the Netherlands) or a 1.5-Tesla Siemens Aera (Siemens Healthcare, Erlangen, Germany) using a multi-channel body coil.\u003c/p\u003e\u003cp\u003eThe standard imaging protocol consisted of multiplanar, single-shot, fast spin-echo T2-weighted imaging, gradient echo T1-weighted imaging, and balanced steady state free precession T2-weighted imaging and axial and sagittal DWI of the brain and the spine respectively. Isotropic diffusion weighted images and ADC maps were automatically generated using a vendor-specific program.\u003c/p\u003e\u003cp\u003eThe sequences were performed using 3 mm slice thickness, 3 mm slice overlap, 1550ms repetition time and 140ms time to echo, with the following settings: field of view, 280 mm \u0026times; 280 mm; matrix, 128 \u0026times; 128; voxel size, 2.5 mm \u0026times; 2.5 mm \u0026times; 4.0 mm. Diffusion weighted sequences used a b-value of 0 and 800 mm\u003csup\u003e2\u003c/sup\u003e/s.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003e- DWI analysis (Figure 1)\u003c/h3\u003e\n\u003cp\u003e\u003c/p\u003e\u003cp\u003eDWI images were anonymized and processed using ITK-SNAP [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Regions-of-interest (ROIs) were manually drawn on ADC maps at two levels: (1) at the anatomical level of the lesion and (2) three levels above(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In case of hydromyelia, only spinal tissue excluding CSF was analyzed (Supplementary Fig.\u0026nbsp;1). Given the limitations of MRI in distinguishing syringomyelia from hydromyelia, the term 'syrinx' was used throughout to describe dilated central canal or parenchymal cavities. Each ROI was measured twice by the same blinded rater (R.C.), and the average value was used. A subset of 12 cases was reviewed by an experienced pediatric neuroradiologist (T.H.) to assess ROI placement reproducibility. All ADC maps were visually inspected for artifacts such as motion, distortion, and signal dropouts.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e- Statistical analysis\u003c/h2\u003e\u003cp\u003eData analysis was performed using the Statistical Package for Social Sciences (SPSS), version 21.0 (IBM Corporation, Armonk, NY, USA). Quantitative variables were expressed as median [interquartile range] if they had a non-normal distribution (assessed by Kolmogorov test) and compared using a Mann-Whitney U test or expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation if they had a normal distribution and compared using t-test. Pearson\u0026rsquo;s X\u003csup\u003e2\u003c/sup\u003e or Fisher\u0026rsquo;s exact tests were used to compare qualitative data respectively. Ordinal regression assessed ADC metrics across ambulation categories. Intra-class correlation coefficient evaluated inter- and intra- rater agreement. ROC curve analysis and Youden index [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] determined optimal ADC cut-offs for each outcome. Logistic regression models adjusted for lesion level and hydrocephalus assessed associations between ADC and outcomes. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e- \u003cstrong\u003eCharacteristics of the cohort\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of 197 children who underwent prenatal MMC repair (150 fetoscopic, 47 open-hysterotomy), 36 met inclusion criteria. Exclusions included lack of spinal DWI at 12 months (n=75), age \u0026lt; 12 or \u0026gt; 30 months at scan (n=71), and incomplete follow-up (n=15) (Figure 2).\u003c/p\u003e\n\u003cp\u003eMedian gestational age at repair was 24.9 [22.3–25.9] weeks. Of the 36 children, 63.9% were female, 61.1% had cystic lesions, and 80.6% had an anatomical defect below L2. Median gestational age at birth was 37.5 [30.3–40.9] weeks, and 22.2% had clubfeet. At 12 months, 72.2% had intact S1 motor function and 67.7% had intact S1 sensory level. Anticholinergic treatment was required in 30.5% and CIC in 22.2%. At 30 months, 63.9% walked independently. Syrinx was present in 16.7%.\u0026nbsp;Hydrocephalus treatment was required in 25% of the cases during the first year of life. At 30 months of life, 63.9% of children in this cohort were able to walk independently.\u003c/p\u003e\n\u003cp\u003e- \u003cstrong\u003eMotor function at 12 months of life (Table 1)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChildren with intact S1 motor function had significantly higher ADC at the lesion level (1.251 [1.001–1.891] ×10⁻⁶ mm²/s) compared to those with worse motor function (1.193 [1.001–1.300], p = 0.01).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe best ADC cut-off to predict intact S1 motor level was 1.305 ×10⁻⁶ mm²/s (Table 2). After adjusting for lesion level and hydrocephalus, this threshold was associated with 11.1-fold higher odds of achieving S1 motor function.\u003c/p\u003e\n\u003cp\u003eNo difference was observed in ADC values measured 3 levels above the lesion (Table 1)\u003c/p\u003e\n\u003cp\u003e- \u003cstrong\u003eSensory level at 12 months of life (Table 3)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChildren with intact S1 sensory level had higher lesion-level ADC (1.362 [1.120–1.740]) than those with worse sensory function (1.212 [1.041–1.378], p = 0.02).\u003c/p\u003e\n\u003cp\u003eAn ADC cut-off of 1.314 ×10⁻⁶ mm²/s predicted intact S1 sensory level (aOR 15.9, adjusted for lesion level and hydrocephalus) (Table 2).\u003c/p\u003e\n\u003cp\u003eADC values above the lesion were not significantly different between groups (Table 3).\u003c/p\u003e\n\u003cp\u003e- \u003cstrong\u003eUrological outcomes at 12 months of life (Table 4)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChildren requiring anticholinergics had lower ADC at the lesion (1.223 [1.041–1.400]) compared to those who did not (1.315 [1.130–1.739], p = 0.04). \u0026nbsp;Similarly, those requiring CIC had lower ADC (1.212 [1.120–1.319]) versus those who did not (1.327 [1.041–1.739], p = 0.04).\u003c/p\u003e\n\u003cp\u003eADC thresholds predicting absence of urological dysfunction were (Table 2):\u003c/p\u003e\n\u003cp\u003e· Anticholinergic treatment: 1.305 ×10⁻⁶ mm²/s (not needing treatment if above threshold)\u003c/p\u003e\n\u003cp\u003e· CIC: 1.336 ×10⁻⁶ mm²/s. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eChildren who had an ADC value at the level of the lesion above 1.336\u0026nbsp;x10\u003csup\u003e-6\u003c/sup\u003e mm²/s had 9.93 more chances of not requiring CIC compared to cases with ADC value lower than this cut off, after adjusting by the anatomical level of lesion and the need for hydrocephalus treatment (Table 2).\u003c/p\u003e\n\u003cp\u003eNo significant differences were found in ADC measured above the lesion (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAmbulation at 30 months of life (Table 5)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIndependent walkers had higher lesion-level ADC (1.362 [1.041–1.891]) than non-independent walkers (1.187 [1.001–1.456], p = 0.02).\u0026nbsp;ADC metrics at the lesion level were significantly higher in children able to walk independently (1.362 [1.041-1.891] x10\u003csup\u003e-6\u003c/sup\u003e mm²/s) as compared to children who required assistive devices to walk (1.217[1.148-1.319] x10\u003csup\u003e-6\u003c/sup\u003e mm²/s) and those who were not ambulatory (1.141[1.101-1.456] x10\u003csup\u003e-6\u003c/sup\u003e mm²/s, p = 0.03) (Figure 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAt the level of lesion, ADC equal to 1.336\u0026nbsp;x10\u003csup\u003e-6\u003c/sup\u003e mm²/s was the best cut-off to predict independent ambulation.\u0026nbsp;Children who had an ADC value at the level of the lesion of above 1.336\u0026nbsp;x10\u003csup\u003e-6\u003c/sup\u003e mm²/s had 17.47 more chances of being an independent ambulator compared to cases with ADC value lower than this cut off after adjusting on the anatomical level of lesion and the need for hydrocephalus treatment (Table 2).\u003c/p\u003e\n\u003cp\u003eThere were no significant differences in ADC metrics assessed at 3 levels above the lesion (Table 5).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur results suggest that spinal cord diffusivity can be reliably evaluated using DWI in children following prenatal MMC repair, and that ADC metrics are associated with neurological outcomes. Children with better outcomes (S1 motor/sensory level, independent ambulation, no need for anticholinergics or CIC) showed higher ADC values at the lesion level compared to children with worse neurological outcomes.\u003c/p\u003e\u003cp\u003eThese findings are aligned with prior reports that show how despite having an in-utero repair, MMC is associated with significant long term neurological morbidity including motor and sensory deficits and sphincter dysfunction [\u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In our study, 72% of children had intact S1 MF at 12 months of age, 64% were able to walk independently, 30% had urological dysfunction requiring CIC and 22% needed anticholinergic medication.\u003c/p\u003e\u003cp\u003eThe spinal cord in MMC is injured through both primary (neurulation failure) and secondary (mechanical, chemical) mechanisms [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The open neural tube leads to CSF leakage, hindbrain herniation, and increased intracranial pressure, with subsequent hypoperfusion and demyelination. Exposure of the spinal tissue to amniotic fluid contributes to motor neuron loss, particularly at and below the lesion [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Our findings confirm that diffusivity changes are most pronounced at the lesion level, with no significant changes three levels above.\u003c/p\u003e\u003cp\u003eSeveral studies have reported significant histological alterations in the spinal cord in patients with MMC. Hutchins \u003cem\u003eet al\u003c/em\u003e reported a range of 20\u0026ndash;100% tissue loss in the spinal cords of fetuses with MMC [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Sival \u003cem\u003eet al\u003c/em\u003e, reported a reduced number and abnormal positioning in lower motor neurons, aberrant spinal blood vessels and abnormalities of the central canal [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. In all cases, spinal integrity was better preserved in the cranial rather than the caudal direction relative to the neural tube defect. Ben Miled \u003cem\u003eet al\u003c/em\u003e, demonstrated significant neuronal loss in the spinal cord in fetuses with MMC who underwent termination of pregnancy [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. They reported early, severe and progressive loss of motor neurons, especially at the level of the exposed spinal cord, but also above the lesion to a much lesser degree. We demonstrated that the most significant microstructural changes were at the level of the defect but not at higher levels above the lesion. By ensuring a watertight repair at midgestation and by reversing the hindbrain herniation, it is hypothesized that prenatal repair protects the spinal cord (and limits the progression of ongoing injury), either by reducing the exposure of the neural elements to the amniotic fluid, or by reducing the compression of the brainstem and spinal cord caused by hindbrain herniation [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDWI appears to add indirect information to our armamentarium regarding central nervous system microstructure, over and above what can be obtained using conventional MRI [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Previous reports have shown how DWI is able to detect differences in the cellularity of the spinal cord in lesions such as acute spinal cord ischemia, spinal cord tumors, anterior spinal artery infarction, myelitis and lesions associated with multiple sclerosis [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. We believe that our study is the first to document the spinal cord diffusivity with DWI after prenatal MMC repair.\u003c/p\u003e\u003cp\u003eWe conclude that children with adverse neurological outcomes present with reduced ADC metrics. The observed decrease in ADC metrics may be associated with, or indicate, an absolute decrease (or loss) of motor neurons and/or the fibrous remodeling of the spinal cord secondary to the primary injury rather than due to the prenatal MMC repair. Fibrotic scar formation after a spinal cord injury includes the migration, proliferation and extracellular matrix deposition of fibroblasts. The fibrotic scar is thought to maintain tissue integrity and limit inflammation after spinal cord injury [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. During scar formation, the complex assembly of collagen fibers, proteoglycan, astrocytes and microglia create a physical barrier to water movement that can reduce ADC metrics [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. However, there is no available histological data to confirm this hypothesis. Our findings indicate that reduced ADC may reflect increased cellular density or gliotic tissue, rather than simply loss of neurons.\u003c/p\u003e\u003cp\u003eSince most MMC patients have neurogenic bladder dysfunction with an ensuing increased risk for renal impairment [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e], it is important to identify those at greatest risk for this complication. Neurologic control of the bladder [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] is a complex process involving central (pontine) control of the synchronization between bladder contraction and relaxation of the internal urethral sphincter during voiding. Innervation of the bladder includes parasympathetic fibers (primary innervation) arising from the S2-S4 cord segments, sympathetic fibers (bladder motor activity) arising from T11-L3, and somatic fibers arising from S2-S4 (external urethral sphincter). This multifactorial system makes the prediction of urological outcomes in patients with MMC very difficult even after a successful prenatal repair. Our findings show that children who required anticholinergics or CIC had significantly lower ADC values, indicating a potential association between spinal cord microstructure and autonomic function. Our findings suggest that early identification of microstructural spinal abnormalities using DWI could help anticipate urological management needs.\u003c/p\u003e\u003cp\u003eThe potential to predict outcomes as early as 12 months using spinal DWI could assist clinicians and families in long-term care planning. However, the value of in utero DWI remains unexplored. Although current fetal MRI protocols do not include DWI of the spine, future studies should assess whether such imaging could offer earlier prognostic information.\u003c/p\u003e\u003cp\u003eAlthough DWI methodology is well established, inter and intra observed variability studies were performed showing excellent correlation and reliability. One of the main strengths of this study is its novelty and potential future applications as a prognostic biomarker in this complex condition. In addition, all assessments were performed in a single center by a consistent multidisciplinary team limiting variability in data collection and outcome categorization.\u003c/p\u003e\u003cp\u003eSome limitations must be acknowledged. Not all eligible children had DWI sequences at 12 months, which limited sample size. Evaluators were not blinded to surgical history, potentially introducing bias. DWI of the spine is technically challenging due to motion artifacts, low resolution, and poor signal-to-noise ratio. Use of two different MRI systems may have affected ADC comparability. Differentiating white and gray matter was difficult due to small cord dimensions. Lastly, variations in surgical technique over the study period may have influenced outcomes, and no morphological spinal features were assessed.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study suggests a significant association between spinal cord diffusivity and neurological outcomes in children with MMC who have undergone an \u003cem\u003ein utero\u003c/em\u003e repair. Children with intact MF, S1 sensory level, who are able to walk independently, and who did not require anticholinergic or CIC therapies, demonstrated significantly higher ADC metrics in the spinal cord at the level of the lesion as compared to children with worse neurological outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e\u003cp\u003eThis research received no external funding.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualisation \u0026amp; writing (RC, MSC), Data curation (WW, AN, CB), Resources (JM, JC, HC), Formal analysis (RC), Investigation (RJ), Methodology (TH, MSC), Supervision (MB, MSC), review (all co-authors), validation (all co-authors)\u003c/p\u003e\u003ch2\u003eAcknowledgement:\u003c/h2\u003e\u003cp\u003enone\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAvagliano L, Massa V, George TM et al (2019) Overview on neural tube defects: From development to physical characteristics. 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J Urol 200:187\u0026ndash;194. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/J.JURO.2018.02.3101\u003c/span\u003e\u003cspan address=\"10.1016/J.JURO.2018.02.3101\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAmarante MA, Shrensel JA, Tomei KL et al (2012) Management of urological dysfunction in pediatric patients with spinal dysraphism: review of the literature. Neurosurg Focus 33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3171/2012.7.FOCUS12232\u003c/span\u003e\u003cspan address=\"10.3171/2012.7.FOCUS12232\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Motor function at 12 months of age\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"652\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntact motor function -S1 MF- (n=26)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon S1 motor function\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eADC at the level of lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e1.251[1.001-1.891]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.193[1.001-1.300]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eADC 3 levels above the lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e1.247[0.697-2.078]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.363[1.178-2.078]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAge at MF assessment (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e12[7-18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e12[11-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAge at DWI-MRI scan (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e12[11-21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e15[12-21.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eArea of the ROI obtained at the level of lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e7.7[3.1-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6.8[4-9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eArea of the ROI obtained 3 levels above the lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e6[4-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6.5[4-9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eChildren\u0026rsquo;s gender (male, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e18/26(69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e5/10(50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAnatomical level of lesion below L2 (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e22/26(84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7/10(70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eType of lesion (cystic-MMC)(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e14/26(53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8/10(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAt least one club foot at birth (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e3/26(11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e5/10(50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eHydrocephalus treatment during the first year of life (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e6/26(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3/10(30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eType of fetal repair (fetoscopic, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e15/26(57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8/10(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eReversal of Chiari II malformation as observed 6 weeks post fetal surgery (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e24/26(92.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e9/10(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as n(%) or median[range].\u003c/p\u003e\n\u003cp\u003eAbbreviations: S1, sacral one; ADC, Apparent Diffusion Coefficient ; MF: motor function;DWI, Diffusion Weighted Imaging ; ROI, region of interest ; L2, lumbar two level; MMC, myelomeningocele\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Best ADC cut-off measured at the level of lesion to predict neurological outcomes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\" width=\"746\" height=\"562\"\u003e\u003c/p\u003e\n\u003cp\u003eAbbreviations: ADC, Apparent Diffusion Coefficient ; AUC, area under curve; Se, Sensitivity; Sp, Specificity; aOR, adjusted odds ratio; CI95%, 95% confidence interval; S1, sacral one level; CIC, clean intermittent catheterization\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.Best ADC cut-off to predict neurological outcomes with the best sensitivity and specificity was determined by ROC curve analysis and Youden test. ADC is expressed in mm/s\u0026sup2;.\u003c/p\u003e\n\u003cp\u003e2. Adjusted by the level of lesion and the need for hydrocephalus treatment\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Sensory level at 12 months of age\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"643\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eS1 sensory level (n=21)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot S1 sensory level (n=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eADC level of lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.362[1.120-1.740]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.212[1.041-1.378]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eADC 3 levels above the lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.223[0.698-2.078]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.352[1.179-1.719]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAge at sensory testing (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12[7-28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e12[11-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAge at DWI-MRI scan (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12[11-18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e12[12-21.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eArea of the ROI obtained at the level of lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8.8[3.1-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.1[4.2-6.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eArea of the ROI obtained 3 levels above the lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6.1[4-11.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.9[3.8-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eChildren\u0026rsquo;s gender (male, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9/21(42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2/9(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAnatomical level of lesion below L2 (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15/21(71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8/9(88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eType of lesion (cystic-MMC)(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12/21(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5/9(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAt least one club foot at birth (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4/21(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2/9(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eHydrocephalus treatment during the first year of life (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7/21(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2/9(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eType of fetal repair (fetoscopic, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12/21(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7/9(77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eReversal of Chiari II malformation as observed 6 weeks post fetal surgery (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e19/21(90.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e9/9(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as n (%) or median [range].\u003c/p\u003e\n\u003cp\u003eAbbreviations: S1, sacral one; ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Urological outcomes at 12 months of age\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeed anticholinergic treatment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo need for anticholinergic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003etreatment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=26)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeed clean intermittent catheterization\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo clean intermittent catheterization (n=27)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eADC level of lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e1.223[1.041-1.400]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1.315[1.130-1.739]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e1.212[1.120-1.319]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1.327[1.041-1.739]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eADC 3 levels above (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e1.464[1.180-1.687]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1.219[0.698-2.078]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e1.299[1.185-1.403]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1.247[1.068-1.710]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eAge at urological evaluation (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e14.5[12-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e13[7-18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e14.5[12-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e13[7-18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eAge at DWI-MRI (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e12[11-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e12[11-24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e12[12-12.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e12[11-23.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eArea of the ROI obtained at the level of lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e6.8[6.1-8.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e7[3.1-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e6.7[4.2-8.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7.9[3.1-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eArea of the ROI obtained 3 levels above the lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.1[4-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e5.2[4.2-8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e6.1[4-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e6[4.2-9.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eChildren\u0026rsquo;s gender (male, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e6/10(60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e7/26(26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e4/9(44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e9/27(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eAnatomical level of lesion below L2 (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8/10(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e21/26(80.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e8/9(88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e21/27(77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eType of lesion (cystic-MMC)(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7/10(70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e15/26(57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e6/9(66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e16/27(59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eHydrocephalus treatment during the first year of life (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3/10(30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e6/26(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2/9(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7/27(25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eType of fetal repair (fetoscopic, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4/10(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e19/26(73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e4/9(44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e19/27(70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eReversal of Chiari II malformation as observed 6 weeks post fetal surgery (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e10/10(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e23/26(88.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e9/9(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e24/27(88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as n (%) or median [range].\u003c/p\u003e\n\u003cp\u003ea. Represents the comparison between anticholinergics vs no anticholinergics\u003c/p\u003e\n\u003cp\u003eb. Represents the comparison between clean intermittent catheterization vs no clean intermittent catheterization\u003c/p\u003e\n\u003cp\u003eAbbreviations: CIC, Clean Intermittent Catheterization; ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Comparison between children able to walk independently and children not walking independently\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 284px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWalking independently (n=23)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon walking independently at 30 months of life (n=13)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eADC level of lesion (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.362[1.041-1.891]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.187[1.001-1.456]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eADC 3 levels above (x10\u003csup\u003e-6\u003c/sup\u003e mm\u0026sup2;/s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.214[0.933-1.829]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.352[0.697-2.078]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAge at ambulation assessment (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e37[24-74]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e38[30-63]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAge at DWI-MRI scan (months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e12[11-15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19[11.5-24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eArea of the ROI obtained at the level of lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6.2[3.1-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7.9[6.7-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eArea of the ROI obtained 3 levels above the lesion (mm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.3[4-8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6.4[4.1-20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eChildren\u0026rsquo;s gender (male, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e8/23(34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5/13(38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAnatomical level of lesion below L2 (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19/23(82.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10/13(76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eType of lesion (cystic-MMC)(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10/23(43.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4/13(30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eAt least one club foot at birth (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6/23(26.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2/13(15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eHydrocephalus treatment during the first year of life (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5/23(21.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4/13(30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eType of fetal repair (fetoscopic, %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16/23(69.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7/13(53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eDetethering surgery required by 30 months (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4/23(17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4/13(30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003eReversal of Chiari II malformation as observed 6 weeks post fetal surgery (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e22/23(95.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e11/13(84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as n (%) or median[range].\u003c/p\u003e\n\u003cp\u003eAbbreviations: ADC, Apparent Diffusion Coefficient; DWI, Diffusion Weighted Imaging; ROI, region of interest; L2, lumbar two level; MMC, myelomeningocele\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"pediatric-radiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prad","sideBox":"Learn more about [Pediatric Radiology](http://link.springer.com/journal/247)","snPcode":"247","submissionUrl":"https://submission.nature.com/new-submission/247/3","title":"Pediatric Radiology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7495159/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7495159/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eLittle is known about the impact of spinal cord microstructural alterations after prenatal myelomeningocele (MMC) repair and their association with neurological outcomes.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo assess spinal cord diffusivity using diffusion-weighted imaging (DWI) at 12 months of age in children who underwent prenatal MMC repair and to explore associations with clinical outcomes.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eThis retrospective cohort study included children who underwent prenatal MMC repair at XXXX between November 2011 and May 2023. All children met MOMS trial inclusion criteria. DWI was performed at approximately 12 months of age, and apparent diffusion coefficient (ADC) metrics were obtained at the level of the spinal lesion. Neurological outcomes included intact S1 motor and sensory level, need for anticholinergic therapy or clean intermittent catheterization at 12 months, and ambulatory status at 30 months. Associations between ADC (expressed as 10⁻⁶ mm\u0026sup2;/s) and outcomes were assessed using the Mann-Whitney U test.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThirty-six children were included (23 fetoscopic, 13 open-hysterotomy repairs). ADC was significantly higher in children with intact S1 motor function (1.251 [1.001\u0026ndash;1.891] vs. 1.193 [1.001-1.300], p\u0026thinsp;=\u0026thinsp;0.01), intact S1 sensory level (1.362 [1.120\u0026ndash;1.740] vs. 1.212 [1.041\u0026ndash;1.378], p\u0026thinsp;=\u0026thinsp;0.02), no anticholinergic therapy (1.315 [1.130\u0026ndash;1.697] vs. 1.223 [1.041-1.400], p\u0026thinsp;=\u0026thinsp;0.04), no catheterization (1.327 [1.041\u0026ndash;1.739] vs. 1.212 [1.120\u0026ndash;1.319], p\u0026thinsp;=\u0026thinsp;0.04), and ambulatory status at 30 months (1.362 [1.041\u0026ndash;1.891] vs. 1.187 [1.001\u0026ndash;1.456], p\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eLower ADC values at the lesion level were associated with adverse neurological and urological outcomes in children after prenatal MMC repair, suggesting that DWI may provide early imaging biomarkers of spinal cord integrity.\u003c/p\u003e","manuscriptTitle":"Diffusion Weighted Imaging of the spinal cord in children after a prenatal myelomeningocele repair","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-09 13:27:55","doi":"10.21203/rs.3.rs-7495159/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-14T20:22:30+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-28T18:45:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-28T03:53:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-26T15:55:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"52452015593792649195301250170823047327","date":"2025-09-25T14:58:51+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-24T06:48:29+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-19T22:44:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109623199359488060632867364489090376589","date":"2025-09-05T11:08:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"208140160771703123523525819344434884183","date":"2025-09-04T18:08:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"268847771826103225359344858582985459067","date":"2025-09-04T15:25:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"294179791862889618041571908167198435594","date":"2025-09-03T04:06:14+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-03T02:42:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-03T00:18:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-03T00:18:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"Pediatric Radiology","date":"2025-08-30T12:02:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"pediatric-radiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prad","sideBox":"Learn more about [Pediatric Radiology](http://link.springer.com/journal/247)","snPcode":"247","submissionUrl":"https://submission.nature.com/new-submission/247/3","title":"Pediatric Radiology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4d6fffb4-27a4-43df-8755-596523ca9442","owner":[],"postedDate":"September 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:04:27+00:00","versionOfRecord":{"articleIdentity":"rs-7495159","link":"https://doi.org/10.1007/s00247-026-06556-8","journal":{"identity":"pediatric-radiology","isVorOnly":false,"title":"Pediatric Radiology"},"publishedOn":"2026-03-03 15:57:32","publishedOnDateReadable":"March 3rd, 2026"},"versionCreatedAt":"2025-09-09 13:27:55","video":"","vorDoi":"10.1007/s00247-026-06556-8","vorDoiUrl":"https://doi.org/10.1007/s00247-026-06556-8","workflowStages":[]},"version":"v1","identity":"rs-7495159","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7495159","identity":"rs-7495159","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}