Case Report
Time-Spatial Labeling Inversion Pulse Magnetic Resonance Imaging of Cystic Lesions of the Spinal Cord Tatsuya Ishibe, Fukuji Senzoku, Yusuke Kamba, Noboru Ikeda, Yoshihiro Mikawa
Key words Arachnoid cyst - Communicating hole - Magnetic resonance imaging - Spinal cord - Time-spatial labeling inversion pulse -
Abbreviations and Acronyms BBTI: Black blood time interval CSF: Cerebrospinal fluid SEAC: Spinal extradural arachnoid cyst SIAC: Spinal intradural arachnoid cyst T-SLIP MRI: Time-spatial labeling inversion pulse magnetic resonance imaging Center for Spine Surgery, Japan Community Healthcare Organization Tamatsukuri Hospital, Tamayu-cho, Matsue-shi, Shimane, Japan To whom correspondence should be addressed: Tatsuya Ishibe, M.D., Ph.D. [E-mail: [email protected]] Citation: World Neurosurg. (2016) 88:693.e13-693.e21. http://dx.doi.org/10.1016/j.wneu.2015.12.051 Supplementary digital content available online. Journal homepage: www.WORLDNEUROSURGERY.org Available online: www.sciencedirect.com 1878-8750/$ - see front matter ª 2016 Elsevier Inc. All rights reserved.
- BACKGROUND:
Cystic lesions of the spinal cord such as spinal intradural arachnoid cysts (SIACs) and spinal extradural arachnoid cysts (SEACs) contain cerebrospinal fluid (CSF). The pathology of these lesions is often difficult to understand because it is difficult to detect abnormal CSF flow by conventional magnetic resonance imaging (MRI) or myelography. We preliminarily evaluated the usefulness of time-spatial labeling inversion pulse magnetic resonance imaging (T-SLIP MRI) of cystic lesions of the spinal cord.
- METHODS:
T-SLIP MRI was applied to the following 6 consecutive cystic lesions of the spinal cord: 3 SEACs, 1 SIAC, 1 spinal intramedullary cyst associated with adhesive arachnoiditis, and 1 chronic pseudomeningocele. Information obtained by T-SLIP MRI was evaluated with regard to the following: 1) whether exclusive pathologic information was obtained, 2) whether this information affected the therapeutic strategy, and 3) the time required for T-SLIP MRI.
- RESULTS:
Exclusive information was obtained in all 6 cases. In SEACs and the intramedullary cyst, pathologic CSF flow into the cyst was directly visualized, enabling us to narrow the therapeutic intervention targets. In SIAC, exclusive information involved detection of the cystic cranial wall and the absence of the caudal wall, enabling us to omit the exploration of the caudal wall. The examination required as long as 80 minutes for SIAC and
Time-Spatial Labeling Inversion Pulse Magnetic Resonance Imaging of Cystic Lesions of the Spinal Cord Tatsuya Ishibe, Fukuji Senzoku, Yusuke Kamba, Noboru Ikeda, Yoshihiro Mikawa
Key words Arachnoid cyst - Communicating hole - Magnetic resonance imaging - Spinal cord - Time-spatial labeling inversion pulse -
Abbreviations and Acronyms BBTI: Black blood time interval CSF: Cerebrospinal fluid SEAC: Spinal extradural arachnoid cyst SIAC: Spinal intradural arachnoid cyst T-SLIP MRI: Time-spatial labeling inversion pulse magnetic resonance imaging Center for Spine Surgery, Japan Community Healthcare Organization Tamatsukuri Hospital, Tamayu-cho, Matsue-shi, Shimane, Japan To whom correspondence should be addressed: Tatsuya Ishibe, M.D., Ph.D. [E-mail: [email protected]] Citation: World Neurosurg. (2016) 88:693.e13-693.e21. http://dx.doi.org/10.1016/j.wneu.2015.12.051 Supplementary digital content available online. Journal homepage: www.WORLDNEUROSURGERY.org Available online: www.sciencedirect.com 1878-8750/$ - see front matter ª 2016 Elsevier Inc. All rights reserved.
- BACKGROUND:
Cystic lesions of the spinal cord such as spinal intradural arachnoid cysts (SIACs) and spinal extradural arachnoid cysts (SEACs) contain cerebrospinal fluid (CSF). The pathology of these lesions is often difficult to understand because it is difficult to detect abnormal CSF flow by conventional magnetic resonance imaging (MRI) or myelography. We preliminarily evaluated the usefulness of time-spatial labeling inversion pulse magnetic resonance imaging (T-SLIP MRI) of cystic lesions of the spinal cord.
- METHODS:
T-SLIP MRI was applied to the following 6 consecutive cystic lesions of the spinal cord: 3 SEACs, 1 SIAC, 1 spinal intramedullary cyst associated with adhesive arachnoiditis, and 1 chronic pseudomeningocele. Information obtained by T-SLIP MRI was evaluated with regard to the following: 1) whether exclusive pathologic information was obtained, 2) whether this information affected the therapeutic strategy, and 3) the time required for T-SLIP MRI.
- RESULTS:
Exclusive information was obtained in all 6 cases. In SEACs and the intramedullary cyst, pathologic CSF flow into the cyst was directly visualized, enabling us to narrow the therapeutic intervention targets. In SIAC, exclusive information involved detection of the cystic cranial wall and the absence of the caudal wall, enabling us to omit the exploration of the caudal wall. The examination required as long as 80 minutes for SIAC and
