Interesting Image

Hybrid Renal Cortical Imaging with Single Photon Emission Computerized Tomography/Computed Tomography in a Pediatric Patient with Severe Caudal Regression Syndrome


  • Selin Kesim
  • Halil Turgut Turoğlu
  • Salih Özgüven
  • Tunç Öneş
  • Tanju Yusuf Erdil

Received Date: 04.08.2020 Accepted Date: 24.11.2020 Mol Imaging Radionucl Ther 2022;31(1):69-71 PMID: 35114757

Caudal regression syndrome (CRS) or sacral agenesis is a rarely seen malformation with a varying degree of structural abnormalities, including multiorgan system dysfunctions, reported with higher incidence among children of mothers with diabetes, as in this case. Spinal anomalies can range from coccyx hemiagenesis to the total absence of lower lumbar vertebrae and sacrum in most severe cases. Herein, we have presented a 9-year-old patient with CRS who had renal failure. Technetium-99m dimercaptosuccinic acid renal scintigraphy revealed bilaterally non-functioning kidneys with no renal cortical uptake. Renal anomalies in CRS with vertebral, anorectal, cardiac, trachea-esophageal, renal, and limb anomalies association include one-sided renal agenesis, multicystic dysplastic kidneys, and ureter duplications.

Keywords: Caudal regression syndrome, sacral agenesis, VACTERL association, Tc-99m DMSA renal scintigraphy, SPECT/CT


Informed Consent: We have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Surgical and Medical Practices: S.K., H.T.T., S.Ö., T.Ö., T.Y.E., Concept: S.K., H.T.T., Design: S.K., H.T.T., Data Collection or Processing: S.K., H.T.T., Literature Search: S.K., H.T.T, Writing: S.K., H.T.T.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.


  1. Sharma P, Kumar S, Jaiswal A. Clinico-radiologic Findings in Group II caudal regression syndrome. J Clin Imaging Sci 2013;3:26.
  2. Zaw W, Stone DG. Caudal regression syndrome in twin pregnancy with type II diabetes. J Perinatol 2002;22:171-174.
  3. Cunningham BK, Khromykh A, Martinez AF, Carney T, Hadley DW, Solomon BD. Analysis of renal anomalies in VACTERL association. Birth Defects Res A Clin Mol Teratol 2014;100:801-805.
  4. Renshaw TS. Sacral Agenesis. The Pediatric Spine -Principles and Practice. Raven Press, New York. 1994;1:2214.
  5. Fayyaz A, Ilyas M, Iqbal O. Pre-natal diagnosis of caudal regression syndrome. J Coll Physicians Surg Pak 2007;17:425-426.
  6. Karacalioglu AO, Soylu K, Emer O, Ayan A, Ozguven M. Incidental finding of sacral hemiagenesis on the (99m)Tc-MDP bone scan as a casual regression syndrome type II. Hell J Nucl Med 2008;11:175-178.
  7. Nguyen BD, Civelek AC. Bone scintigraphy of caudal regression syndrome. Clin Nucl Med 1996;21:802-804.
  8. Harisankar CN, Mittal BR, Bhattacharya A, Sunil HV, Singh B, Rao KL. Potential diagnostic role of renal scintigraphy in the management of patients with high anorectal malformation. Hell J Nucl Med 2009;12:260-265.