Findings
- Focal ventral deviation of the spinal cord from the level of the inferior endplate of T4 through the mid T5 vertebral body with a C-shaped concavity along the dorsal margin of the cord at this level and likely dural defect with no CSF signal visualized along the ventral aspect of the deviated cord
- Thin CSF signal ventral epidural collection immediately cranial and caudal to the cord contour abnormality extending throughout the thoracic spine
- Mild multilevel degenerative disc disease with a small posterior disc bulge at T7-T8 and multilevel mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neural foraminal stenosis
- No abnormal cord signal
- No abnormal marrow signal
- Normal alignment
Diagnosis
Spinal cord herniation
Sample Report
Focal ventral displacement of the spinal cord at the level of T4-T5 with likely associated dural defect concerning for spinal cord herniation. The differential diagnosis also includes a dorsal arachnoid cyst, which is considered less likely given lack of a defined collection and CSF pulsation artifact along the dorsal aspect of the cord at this level, and arachnoid web, though the cord contour abnormality is not as typical for an arachnoid web. Recommend neurosurgical evaluation and consideration of CT myelogram for further assessment.
Thin CSF signal ventral epidural collection immediately cranial and caudal to the cord contour abnormality extending throughout the thoracic spine concerning for CSF leak associated with the dural defect. No significant associated mass effect on the cord.
Discussion