 Counting of the vertebral bodies is limited due to motion between upper and lower spine sequences. L5 is probably sacralized. The last fully formed disc is at L4-L5 and the L5-S1 disc appears rudimentary. The last visualized rib is at T11.The conus medullaris is seen at the level of mid L1 with non-thickened fatty filum. The fatty filum extends from L1 to the distal end of the thecal sac. There is appropriate the ventral motion of the cord on prone imaging. There is prominence of the central canal at the distal cord and the conus. The central canal measures 2 x 2 mm at the mid T11 level although there is further more ill-defined prominence of the central spinal canal from T6 to T12.There is prominence of the CSF space along the posterior and inferior aspect of the cerebellum which favors mega cisterna magna. The fourth ventricle does not appear enlarged. There may be minimal inferior vermian hypoplasia although this is difficult to completely assess on this dedicated spine exam.The bladder is severely distended.
1. Normal conus termination with non-thickened fatty filum. Appropriate ventral motion of the cord on prone imaging. No MR imaging findings to support tethered cord.2. Trace prominence of the central canal from T6 to T12, most conspicuous at the mid T11 level where it measures up to 2 mm. The more caudal findings may relate to a ventricularis terminalis, although the greater extent of subtle abnormal signal may relate to underlying trace syringohydromyelia. Follow-up imaging and clinical correlation may be helpful.3. Significant focal prominence of the CSF space along the posterior and inferior aspect of the cerebellum which favors mega cisterna magna along the Dandy-Walker spectrum with questioned mild inferior vermian hypoplasia. If there is clinical concern, MRI of the brain may be obtained for further evaluation.