Clinical question: Evaluate for spinal anomalies, Chiari, syrinx, tethered cord. Signs and symptoms: Scoliosis. Nonenhanced total spine MRI:Evaluation of the cervical spine demonstrate no evidence of Chiari malformation or cervical syrinx.There is normal anatomical development of vertebral column.There is a central broad-based bulging disk and C5 -- C6 which results in effacement of the ventral subarachnoid space, flattening deformity and posterior displacement of the cord and central spinal stenosis. CSF flow study at the level of foramen magnum demonstrate normal biphasic flow through the foramen magnum both anterior and posterior to the cord. Biphasic flow is also noted through the fourth ventricle and the aqueduct.Evaluation of thoracic spine demonstrate a metal demarcated centrally located fluid signal intensity extending from T11 inferiorly to T12 -- L1 disk level. It measures maximum of approximately 1.9 mm caliber. The finding could represent a prominent central canal or a tiny syrinx. The finding does not extend into the conus which terminates at the L1 -- L2 disk level.There is no convincing evidence of segmentation anomaly. No evidence of central spinal stenosis or any significant neural foraminal compromise. Mild asymmetric hypertrophy changes of posterior elements secondary to sclerosis is present.Evaluation of the lumbosacral spine demonstrate no evidence of segmentation anomaly.There is normal signal intensity of cauda equina and in particular no evidence of fatty filum detected.There is distinct anterior movement of the lower thoracic cord, conus and proximal cauda equina on prone sagittal T2-weighted images when compared with supine series.
1.Examination demonstrates no evidence of Chiari malformation or tethered cord as is questioned clinically.2.Tiny focus of T2 hyperintensity in the center of the cord extending from T11 to T12 -- L1 level without extension to the conus. Finding could represent a prominent central canal or a tiny syrinx. There is normal termination of the cord and L1 -- L2 disk level.3.There is anterior movement of the lower cord, conus and proximal cauda equina on sagittal prone series compared to supine.4.There is normal signal intensity of cauda equina.5.There is no detectable segmentation anomaly of the vertebral column, no spinal stenosis or neural foraminal compromise