Closed spinal dysraphism in adult patients

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ESMRMB
European Society for Magnetic Resonance in Medicine and Biology
Official Journal of the European Society for
Magnetic Resonance in Medicine and Biology
magma
Magnetic Resonance
Materials in Physics,
Biology and Medicine
Suppl. 1, Vol. 16, 2003
Book of Abstracts
ESMRMB 2003
20th Annual Scientific Meeting
Rotterdam/NL, Sept. 18-21, 2003
ISSN electronic edition: 1352-8661
DOI: 10.1007/s10334-003-0017-5

Head and Neck S271
malformation=6, type II split cord malformation=8, myelo-
meningocoeles=5, meningocoeles=4, spinal lipoma=2, tight filum
terminale=2, syringomyelic cavities=7, fibrolipoma of filum termi-
nale=5, vertebral segmentation anomalies=7). Small syringomyelic
cavities, septations, and fine dysplastic neural tissues in
myelomeningocoeles and attachment of the filum terminale which
were not seen on conventional images were well demonstrated on
CISS sequence. In addition, more anatomical detail with high T2
resolution and multiplanar reconstruction (MPR)capability were
achieved with this sequence.
Conclusion: CISS sequence imaging is useful in the definition of
complex abnormalities seen in spinal dysraphism which provides
additional information for surgical planning.
513
Closed spinal dysraphism in adult patients
D. S. Ilic-Jankovic1, D. S. T. V. Ilic-Jankovic2; 1Department of
radiology Nis, Clinical Center Nis, Nis, YUGOSLAVIA,
2Department of Radiology Nis, Clinical Center Nis, Nis, Y-
UGOSLAVIA.
Purpose: The aim of this study is to present the radiological
findings and results of neurosurgical intervention in two adult
patients with closed spinal dysraphisms.
Patients and Methods: Review of two mail patients (26 and 32
years old) presented with symptoms and signs of myelopathy. Both
of them underwent clinical, x-ray, myelography, computed tomog-
raphy (CT) myelography and MRI workup.
Results: In both of the patients the spinal canal anomaly and spina
bifida were present.
The first patient (26 y.), beside this had deep extension of subcuta-
neos lipoma thought the spina bifida and dural deficiency to insert
directly into the defect on the dorsal half of the cord. Ballooning of
the subarachnoidal space to form meningocele was in diameter LL
58mm, AP 4omm and in length 14omm. Careful analysis of imag-
ing findings indicated lipomyeloschisis ( lipomyelomeningocele).
The second mail patient (32 y.) clinically had sphincter dephicien-
cy (bladder and rectum), with other signs of myelopathy.
Radiological findings indicate the large anterior sacral meningo-
cele with sacral dysgenesis.
Surgery was proposed to both of them when they were sympto-
matic and with progressive symptoms. After surgery patients
condition improved and stabilized.
Conclusion: The prognosis of skin-covered spinal dysraphysms is
very good if appropriate diagnosis and care are provided early.
Neonatal resection of these congenital anomalies is necessary to
prevent tethering of the spinal cord that might lead to irreversible
neurological damage if not released.
Prognosis in adult patients without irreversible neurological
damage using appropriate neuroimaging and surgical procedures is
also satisfactory.
Head and Neck
514
Preoperative virtual endoscopy of the cerebellopontine angle:
correlation with surgical findings
V. Nowé1, D. De Ridder2, P. Van de Heyning3, F. L. Wuyts3,
A. M. De Schepper1, P. M. Parizel1; 1Department of Radiology,
Universitair Ziekenhuis Antwerpen (University of Antwerp),
Antwerp, BELGIUM, 2Department of Neurosurgery, Universitair
Ziekenhuis Antwerpen (University of Antwerp), Antwerp,
BELGIUM, 3Department of ENT, Universitair Ziekenhuis
Antwerpen (University of Antwerp), Antwerp, BELGIUM.
Purpose: To determine the clinical value of virtual endoscopy of
the cerebellopontine angle (CPA) in preoperative planning and to
correlate virtual endoscopic findings with peroperative results.
Subjects and Methods: Methods: Thin section (0.6 mm), high
resolution (100 mm FOV, 256 matrix) heavily T2-weighted images
were obtained with a gradient echo sequence (constructive interfer-
ence in steady state (CISS)) through the CPA. Fly-through software
on an independent workstation (Leonardo, Siemens) provided
virtual endoscopy images of the CPA.
Subjects: Ten patients were examined prior to undergoing a
neurosurgical procedure in the posterior fossa via retrosigmoidal
approach.
Peroperative images were compared with preoperative virtual
endoscopy findings, and correlated for anatomic accuracy with
regard to the course and shape of the 7th and 8th cranial nerves,
blood vessels and internal auditory canal. All images were com-
pared independently by two neuroradiologists, a neurosurgeon and
an ENTsurgeon.
Results: Excellent anatomic correlations were found between
preoperative virtual endoscopy images and peroperative findings.
The course of nerves and blood vessels in the CPA was accurately
depicted by virtual endoscopy. In patients with a narrow CPA,
anatomic landmarks were not as clearly visible.
Conclusion: Virtual endoscopy of the CPA provides a non-invasive
view of the anatomical relationships between nerves and blood
vessels, and can be an important tool in planning a surgical proce-
dure. The best correlations were found in patients with a wide CPA
due to atrophy, or tumor.
515
Virtual endoscopy of the cerebellopontine angle in patients
with tinnitus
V. Nowé1, D. De Ridder2, P. Van de Heyning3, X. L. Wang1,
A. M. De Schepper1, P. M. Parizel1; 1Department of Radiology,
Universitair Ziekenhuis Antwerpen (University of Antwerp),
Antwerp, BELGIUM, 2Department of Neurosurgery, Universitair
Ziekenhuis Antwerpen (University of Antwerp), Antwerp,
BELGIUM, 3Department of ENT, Universitair Ziekenhuis
Antwerpen (University of Antwerp), Antwerp, BELGIUM.
Purpose: To investigate by means of MR imaging of the cerebello-
pontine angle (CPA) whether a correlation can be found between
the location of microvascular compressions on the vestibulo-
cochlear nerve and three different clinical subtypes of tinnitus.
To show the accuracy of virtual endoscopy imaging to evaluate the
course of nerves and blood vessels in the CPA.