 Very good morning, everyone. I am Dr. Sifu Khan, second year post-graduate student in the Department of Radio Diagnosis, NRS Medical College and Hospital. And today I'm going to present my paper on diastematomylia, which I have done under my co-authors, my associate professor Dr. Sudhita Basu and my senior resident Dr. Suparna Sange. So, starting with introduction, it's basically diastematomylia is also known as a split cord malformation where it refers to a type of spinal dysgraphism, spina bifida occulta type where there is a longitudinal split in the spinal cord. And sagittal division of the spinal cord into two hemicords each with one central canal dorsal horn and ventral horn is there. So congenital abnormality, which basically accounts for around 5% of all congenital spinal defects. And clinical presentation, basically the majority of the patients are symptomatic and they present with the signs and symptoms of t-third cord, including leg weakness, low back pain, scoliosis, incontinence, and they also have associated abnormalities like meningo, ceil, dermoid, cyst club foot spinal cord lipoma, neuroendric cyst. Then 90% of the patients are females, 90% of t-third cord and 100% have spina bifida. Coming on to the pathology, the condition is believed to occur during the gastrolation stage of development due to abnormal movement and separation of the precursor cells. Specifically, it has been thought that a persistent or abnormalization between the ectoderm and the endoderm creates an additional neuroendric canal, which in turn leads to notocard developing into the two hemicords. An important differential diagnosis is the duplicated spinal cord, also known as diplomylia. Now, there are basically two types. Type one, which has a duplicated durol sac with common midline spur and type two, which has only a single durol sac and impairment would be less marked in type two. Type one, if we see the classical diastomatomylia characterized by duplicated durol sac, hydromylia midline spur, which could be osteosciences, fibros, osteocartilaginous, vertebral abnormalities like spina bifida is very common, hemi vertebrae, vertebrae and skin pigmentation could also be there like hypertricosis, which is hair patch, they are very common. And patients are usually symptomatic, they might have scoliosis and tethered cord syndrome. Type two, which is milder than type one. So there is only single durol sac as you can see in the picture and there's no spur in between and hydromylia may be present, spina bifida may be present. And patients are going to be less symptomatic. The cord splitting, which occurs between L1 and L3 and 50% of the cases and T1 and T12 and 25% of the cases. Now this basically is a 10 days old neonate which presented to the department of pediatrics and with a large swelling and tuft of hair on the back and cleft lip and palate was also there. As you can see in the picture. So extra was done at the level of the D12 to L4 spina bifida was noted with a widened interpedicular distance as visible. And MRI scan was done, there's loss of lumbar curvature and the spinal cord is low line and attached to the posterioris defect and at that level evidence of dastromyla was also there. And the axial T2 image you can see the splitting of the spinal cord into two symmetric hemicords and traversing around the large osteospera which is the prominent osteospera which classifies it as type one dastromyla. Then T1 sagittal image is given and coronal sterimage showing the division of the cord. MRI was basically reported as evidence of spina bifida which was seen involving the lower dorsal and the adjacent lumbar segment spinal cord is averting and opening through the posterioris defect into a cystic swelling which is suggestive of myelomaningo, still loss of lumbar curvature is there and spinal cord is low lying and attached to the posterioris defect syringes was also there but as such CV junction was normal no cerebellar abnormality was there. So, if you see the antinatal ultrasound in such patients the presence of an extra ecogenic focus in the midline between the fetal spine posteriori elements has been described as a reliable science. And plain radiograph you might see multiple spina bifida level widening of interpedentcular distance scoliosis. And clinically what is important is that you might see some cutaneous tigmeta which indicates the dastromyla level in more than 50% of the cases and fontail which is seen in the picture. Then, radiographic findings you might see the level of the lower cord where basically spinal cord malformations are more common and occurring between the level L1 and L3 in 50% of the cases and 25% in between T7 and T12 and spina bifida butterfly or hemi vertebrae might also be there CT is able to better image many of the features, but MRI is the modality of choice for assessing the children with split cord malformations as well as being able to elegantly demonstrate the cord and presence of hydromyla it can also assess for the presence of numerous associated abnormalities. Number of references that have been used. Thank you.