An Incidental Finding of Internal Jugular Vein Ectasia on Cervical Spine Magnetic Resonance Imaging

@#Ectasia or abnormal dilatation of a vessel may affect any vein within the body including the neck region. Internal jugular vein (IJV) ectasia commonly presents as a painless, soft swelling on the neck which appears to be prominent with increased intrapleural pressure such as during Valsalva manoeuvre. To the best of our knowledge, the occurrence of venous ectasia is infrequent with limited number of reports on this anomaly available. However with the advancement of technology especially in imaging modalities, there is improvement in detecting this condition. We describe here an incidental finding of focal IJV ectasia in an elderly lady following a cervical spine magnetic resonance imaging (MRI) for bilateral hand numbness, and discuss the management of this rare presentation.

Should We Recommend Ultrasonography for an Incidental Thyroid Nodule on Additional Cervicothoracic Sagittal T2-Weighted Image of Lumbar Spine MRI?

PURPOSE: To determine whether we should recommend ultrasonography (US) for an incidental thyroid nodule identified by additional cervicothoracic sagittal T2-weighted image (C-T sag T2WI) of lumbar spine magnetic resonance imaging (MRI). MATERIALS AND METHODS: A retrospective study of 61 patients who underwent both lumbar spine MRI and thyroid US between December 2011 and April 2015 was conducted. For all US-found thyroid nodules > 1 cm, investigators evaluated whether there was any correlation between thyroid nodule detectability by C-T sag T2WI and US features such as echogenicity, composition, or suspicion of malignancy. RESULTS: Solid hypoechoic (2/4; 50%) or mixed echoic nodules (4/8; 50%) appeared to be found relatively more easily by C-T sag T2WI than more benign-looking solid isoechoic (1/4; 25%) or spongiform nodules (0/6; 0%). Among six nodules with ultrasonographic suspicion for malignancy, only one nodule was detected by C-T sag T2WI. CONCLUSION: If an incidental thyroid nodule is seen by C-T sag T2WI, it would be better to recommend thyroid US for identifying malignancy.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging

PURPOSE: To evaluate the usefulness of cervicothoracic spine sagittal T2-weighted images (CT SAG T2WIs) included in routine lumbar spine MRI. MATERIALS AND METHODS: Institutional review board approval was obtained and informed consents were waived for this retrospective study. The study group comprised 2,113 patients who underwent lumbar spine MRI from January 2005 to December 2005. CT SAG T2WIs were added in the routine lumbar spine MRIs. Radiologic reports were reviewed retrospectively for pathologic lesions on CT SAG T2WIs by one radiologist. Information of additional cervical or thoracic spine MRI and/or CT for further evaluation of positive findings on CT SAG T2WIs and their treatment were collected by retrospectively reviewing medical records. RESULTS: The CT SAG T2WIs revealed 142 pathologic lesions in 139 (6.58%) of the 2,113 patients. They were easily obtained without positional change in a scan time of less than 2 minutes. Additional cervical or thoracic spine MRI and/or CT for positive findings on CT SAG T2WIs were performed in 13 patients. Seven patients underwent surgical treatment. CONCLUSION: CT SAG T2WIs included in routine lumbar spine MRI were useful in finding the pathologic lesions in cervicothoracic spine for the patients who assumed to have lesions in lumbar spine.

Camptocormia Due to Selective Paraspinal Muscle Atrophy

No abstract available.

Leaked CSF on Spine MRI in a Patient with Syndrome of CSF Hypovolemia

A 34-year-old woman was admitted because of severe orthostatic headache. On CSF examination, the opening pressure was below 30 mmH2O. A spine MRI showed a large collection of extradural fluid indicating that CSF leaked into the extradural space. The headache was resolved by an epidural blood patch. We present a patient with a syndrome of CSF hypovolemia, whose spine MRI showed a large amount of leaked CSF in the epidural space of the spine.

A Case of Intradural Epidermoid Tumor of the Lumbar Spine

Histologically, epidermoid tumors are composed only of dermal epithelium and associated connective tissue. They arise from the epithelial tissue displaced during the closure of the neural tube between the third and fifth weeks of gestation. This tumor accounts for 0.6 to 1.1% of all spinal cord tumors; intradural and extramedullary epidermoid tumors are rarely found within the spinal canal. The authors describe a case of intradural epidermoid tumor, in which The patient presented with low back pain and weakness of the lower extremities. On axial and sagittal T1-weighted magnetic resonance imaging of the lumbar spine, a round, high signal intensity response revealed the presence of an intradural tumor at L3-4; it was totally removed. The pathological and clinical characteristics of epidermoid tumors are discussed.

A Case of Intraspinal Epidermoid Tumor Iatrogenically Occurred Following Previous Lumbar Punctures

Epidermoid tumors rarely occur in the central nervous system. Their incidence among intraspinal canal tumors is even less than 1% in most large series. Epidermoid tumors are generally understood as embryogenic or congenital tumor, however the etiologic importance of previous lumbar punctures in the formation of epidermoids has been also suggested by some papers, and almost confirmed by an extensive literature review and an animal experiment. Recently we have experienced a case of intraspinal epidermoid, which occurred at the same site as a lumbar puncture had been performed to carry out lumbar myelogram. To our knowledge, such a case has never been reported in a scientific journal in Korea yet. In this report we emphasize the importance of using a spinal puncture needle with a stylet in spinal taps, and of considering a lesion in the thoraco-lumbar junction on performing lumbar spine CT scan even in a patient only with lumbar disc symptoms.