Advanced MRI: Visualizing the Plexis Sacralis

This research collaboration is on MRI of the sacral plexus for children having neurogenic bladder dysfuntion due to congenital anomalies. The research is driven by the fact that pediatric urologists are often confronted with children suffering from dysfunctioning of the bladder. When this is neurogenic, this is caused by congenital anomalies, e.g. spina bifida. Although medical intervention leads to safe urinary continence and preservation of renal functioning, the exact mechanisms of the disturbed innervation of the bladder in the various syndromes and individuals is not known. The hypothesis of this study is that anatomical variations exist in the sacral plexus and that these variations can lead to the distorted innervation of the bladder in children having neurogenic bladder due to congenital anomalies.

Technical Medicine Msc student Pasquelle van der Jagt performed her graduation study on this programme at the department of Pediatric Urology and the Image Science Institute at the University Medical Center Utrecht. Pasquelle succeeded to visualize the sacral plexus and its branching nerves by developing and testing a dedicated measuring protocol for a 3T MRI scanner. The protocol applies optimized parameter settings to obtain high resolution Turbo Spin Echo (TSE) and DiffusionTensorImaging (DTI) of the sacral plexus. Healthy volunteers and a single child having neurogenic bladder dysfunction due to spina bifida are investigated. The case study of the boy born with spina bifida indicates a segment in the sacral plexus with a disturbed diffusion, that can be visualized with this advanced DTI-MRI technique. Consequently, this indicates a change in microstructural properties in these segments, which gives first handhelds in the etiology of neurogenic bladder dysfunction.

Pasquelle presented her results at the annual meeting of the Society for Research into Hydrocephalus and Spina Bifida in Nottingham at June 22-25, 2011. For this presentation she has won the prestigious President's prize The President's prize is offered for the best oral presentation that is considered to be translational, i.e. taking an idea from basic science or theory through development to clinical application.