Human Tail: A Case Report

Human tail is a rare congenital anomaly in which a lesion protrudes from the lumbosacrococcygeal region. We encountered a case of human tail involving an intradural lipoma and tethered cord, occurring in a 1-day -old female who presented with an 8 cm-sized tail shown by MRI to arise from the S3-4 level. The cauda equina and film terminale were entrapped by the lipoma, but there were no bony abnormalities.

MR Findings of Spinal Cord in Decompression Sickness

PURPOSE: To determine the MR imaging findings of spinal cord decompression sickness. MATERIALS AND METHODS: We retrospectively analysed the spinal MR images of eight patients (M : 6, F : 2) with decompression sickness affecting the cervical spine (n=1) or thoracic spine (n=7). The observed extent, location, continuity, signal intensity and contrast enhancement pattern of spinal cord lesions were analysed. RESULTS: The chief MR finding was continuous (n=2) or non-continuous (n=3) high signal intensity on T2-weighted images in the posterior paramedian spinal cord. In three cases, additional T2 signal abnormality in the ventral horn of the gray matter was observed. There was no signal intensity abnormality on T1- weighted images or abnormal enhancement on post-Gadolinium T1-weighted images. In one case, cord swelling in addition to T2 signal abnormality was observed. CONCLUSION: MR imaging is useful for evaluating spinal cord lesions in patients with decompression sickness.

Lumbosacral Lipoma: Gadolinium-Enhanced Fat Saturation T1 Weighted MR Image is Necessary?

PURPOSE: To evalute the usefulness of contrast-enhanced fat saturation T1-weighted imaging for the evaluationof spinal lipoma, compared with clinical symptoms and surgical findings. MATERIALS AND METHODS: Ten patients withlipomyelomeningocele, confirmed by surgery, were included in this study. In all cases, conventional spin echoT1-and T2-weighted MR imaging, and contrast-enhanced fat saturation T1-weighted imaging was performed to evaluateclinical symptoms, the position of the conus medullaris, the prescence of cord tethering, and associatedanomalies, and to compare the relative usefulness of the techniques. RESULTS: All ten patients were sufferingfrom lipomyelomeningocele without filum terminale fibrolipoma or intradural lipoma. All cases were associated withcord tethering. As associated anomalies, there were seven cases of syringomyelia without hydrocephalus oranorectal anomaly. To evaluate the position of the spinal conus and the prescence of cord tethering, conventionalT1-weighted imaging was more useful than the contrast-enhanced fat saturation equivalent. CONCLUSION: In patientswith early-stage spinal lipona, MRI is useful for evaluation of the causes and position of cord tethering andassociated anomalies Our results suggest that contrast-enhanced fat saturation T1-weighted images do not provideadditional information concerning spinal lipoma, and that for the diagnosis of this condition, conventional T1 and T2-weighted images are more useful than those obtained by contrast-enhanced fat saturation T1-weighted imaging.

Caudal Regression Syndrome: A Case Report

Caudal regression syndrome is a rare congenital anomaly, which results from a developmental failure of thecaudal mesoderm during the fetal period. We present a case of caudal regression syndrome composed of a spectrum ofanomalies including sirenomelia, dysplasia of the lower lumbar vertebrae, sacrum, coccyx and pelvic bones,genitourinary and anorectal anomalies, and dysplasia of the lung, as seen during infantography and MR imaging.

Redundant Nerve Roots of the Cauda Equina: MR Findings

PURPOSE: To evaluate MR findings of redundant nerve roots (RNR) of the cauda equina. MATERIALS AND METHODS: 17 patients with RNR were studied; eight were men and nine were women, and their ages ranged from 46 to 82 (mean63) years. Diagnoses were established on the basis of T2-weighted sagittal and coronal MRI, which showed a tortuous or coiled configuration of the nerve roots of the cauda equina. MR findings were reviewed for location, magnitude, and signal intensity of redundant nerve roots, and the relationship between magnitude of redundancy and severity of lumbar spinal canal stenosis (LSCS) was evaluated. RESULTS: In all 17 patients, MR showed moderate or severe LSCS caused by herniation or bulging of an intervertebral disc, osteophyte from the vertebral body or facet joint, thickening of the ligamentum flavum, degenerative spondylolisthesis, or a combination of these. T2-weighted sagittal and coronal MR images well clearly showed the location of RNR of the cauda equina; in 16 patients (94%), these were seen above the level of constriction of the spinal canal, and in one case, they were observed below the level of constriction. T2-weighted axial images showed the thecal sac filled with numerous nerve roots. The magnitude of RNR was mild in six cases (35%), moderate in five cases (30%), and severe in six cases (35%). Compared with normal nerve roots, the RNR signal on T2-weighted images was iso-intense. All patients with severe redundancy showed severe LSCS, but not all cases with severe LSCS showed severe redundancy. CONCLUSION: Redundant nerve roots of cauda equina were seen in relatively older patients with moderate or severe LSCS and T2-weighted MR images were accurate in identifying redundancy of nerve roots and evaluating their magnitude and location.