1. What is spina bifida? Spina bifida is a developmental disorder of the vertebral arch in early embryonic life, with incomplete closure of the spinal canal, occasionally accompanied by developmental malformations of the vertebral bodies and intervertebral foramina, which can occur in the cervical, thoracic, lumbar or sacral spine. The lumbosacral region is the most common, with some existing in different parts of the body at the same time. Spina bifida is divided into two main categories: recessive and dominant. Occult spina bifida is common, and the skin in the area of the lesion may be normal, or there may be hyperpigmentation, capillary hemangiomas, skin depressions, and local hairiness. Dominant spina bifida is rare, due to incomplete closure of the vertebral plate, the contents of the spinal canal expand outward through the defect, forming a cystic mass under the skin in the spinal dorsum. 2. What tests should be done when a child has a depression or abscess in the lumbosacral area suspected of spina bifida? When localized skin hirsutism, purple spots, small concavities, pigmentation, and dermatoglyphs are found on the baby’s low back, CT and MRI should be performed as soon as possible. 3.Can the diagnosis be confirmed by ultrasound and MRI? For babies after birth, MRI can clearly show spina bifida and spinal cord, neurological malformations, as well as local adhesions and other pathologies, which can mostly be clearly diagnosed, while B ultrasound is not very helpful for diagnosis. However, for fetuses, ultrasound should be the preferred test. Not every case of spina bifida can be diagnosed by prenatal ultrasound, and about 60-70% of fetuses with spina bifida can be diagnosed. In recent years, prenatal diagnosis has continued to develop, and the screening indexes and protocols for fetal spina bifida are constantly updated, and the detection rate of spina bifida is getting higher and higher. 4.Does the different parts of the MRI have an impact on the final diagnosis? Spina bifida is most common in the lumbosacral region, and some are present in different areas at the same time. When spina bifida is suspected, MRI of the lumbosacral region should be performed first, followed by other areas if necessary. 5.Can the severity of spina bifida be determined by ultrasound and MRI? MRI can clearly show spina bifida and spinal cord, neurological deformities, and local adhesions and other pathological conditions. The diagnosis of spina bifida combined with spinal cord embolism is more clear, and it can mostly show signs such as spinal cord ends moving down, reaching the lumbosacral junction or sacral canal, and local adhesions. If combined with cysts, lipomas, etc. can also be identified. 6.What should I do if my child is too young to cooperate with MRI? Does MRI produce radioactivity that affects the child’s growth and development? Because MRI examinations are long and noisy, sedation (such as chloral hydrate, luminal, etc., and Valium if necessary) should be used routinely for MRI examinations in children under 5 years of age, and sedation is also recommended for children over 5 years of age who cannot cooperate with MRI examinations. Since MRI is magnetic field imaging, there is no radioactivity, so it is harmless to the human body and is relatively safe and will not affect the growth and development of the baby. 7.In addition to ultrasound and MRI, what other tests are needed to diagnose spina bifida? For babies born with spina bifida, MRI can be used to make a clear diagnosis. For babies with vertebral or intervertebral foramina developmental malformations, CT of the spine and 3D reconstruction are also required. Prenatal screening of the fetal spine requires testing for amniotic fluid alpha-fetoprotein (AFP) and maternal serum AFP in addition to ultrasound, and MRI of the abdominopelvic region if necessary. 8. Is it possible to determine whether a fetus will develop spina bifida through prenatal testing? In recent years, prenatal diagnosis has continued to develop, and the screening indicators and protocols for fetal spina bifida are constantly updated, and the detection rate of spina bifida is becoming higher. If other factors are excluded and the AFP value in the blood of the pregnant woman is increased, a detailed ultrasound examination is recommended. MRI and amniocentesis are used to detect AFP in the amniotic fluid when the diagnosis is not clear by ultrasound.