Magnetic resonance imaging in myelocystoceles

Report of two cases

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✓ Two cases of terminal myelocystocele, a rare localized cystic dilatation of the caudal spinal central canal, are reviewed. Magnetic resonance imaging is a useful diagnostic tool for its evaluation. Terminal myelocystocele consists of the following: a myelocystocele which contains a “trumpet-like” flaring of the distal spinal cord central canal and thus is partially lined by ependymal tissue; a meningocele or dilated subarachnoid space located around the myelocystocele, which bulges into the subcutaneous region; and fibrolipomatous tissue surrounding the two cysts. This condition is usually associated with abnormalities of the vertebral column and sacrum as well as compression of the spinal cord and meningocele by a fibrous band. There is a possible relationship of the myelocystocele to teratogens such as loperamide HCl and retinoic acid, although the exact etiology of this entity is not known.

Article Information

Address for Dr. Murovic: Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.

Address reprint requests to: Warwick J. Peacock, M.D., Section of Pediatric Neurosurgery, Division of Neurosurgery, University of California School of Medicine, 10833 Le Conte Avenue, 74-137 Center for the Health Sciences, Los Angeles, California 90024.

© AANS, except where prohibited by US copyright law.

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Figures

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    Case 1. T1-weighted magnetic resonance images showing sagittal (left) and coronal (right) views of the thoracolumbar spine. The myelocystocele is visualized in the sagittal view superior to the meningocele. Note the intramedullary cyst seen on both the sagittal and coronal sections.

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    Case 2. Artist's drawing of the meningocele surrounding the myelocystocele. Inset: T1-weighted magnetic resonance image, sagittal view, showing a T12-L3 intramedullary cyst, terminal myelocystocele, meningocele, and lipoma dorsal and superior to the meningocele and myelocystocele. See also cover.

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    Case 2. T1-weighted magnetic resonance image, axial view, of the myelocystocele shown in Fig. 2.

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    Case 2. Photomicrograph of ependymal tissue obtained at biopsy of the walls of the myelocystocele cavity. H & E, × 243.

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