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Case Challenge: Spine MRI Cases


Spine MRI Case Challenge Pre-Course Activities
2 topics

15b - Answer: A 56 year-old patient with thoracic myelopathy

David Yousem MBA, MD
David M Yousem, MBA, MD
Professor of Radiology, Vice Chairman and Associate Dean
Includes DICOM files

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Case Report

HISTORY: Spinal cord vascular malformation.

Thoracic spine:

There is mild scoliosis. There is otherwise no evidence of significant malalignment. Note is made of an abnormal tangle of vascular flow-voids present along the posterior and left lateral aspects of the spinal cord spanning the T9 level inferiorly to approximately the level of T12. This is best seen on slices 6 and 7 from series 5. There are no definite
intramedullary signal changes.

There are tiny left-sided foraminal disc protrusions at T3-T4, T4-T5, and T5-T6, best seen on the sagittal T2 sequences (slice 7, series 5), which do not contribute to significant neural foraminal narrowing. Subtle disc bulges are seen at other levels of the thoracic spine without significant spinal canal narrowing. For instance, there are mild bulging discs at T7-T8, T8-T9, and T10-T11, minimally indenting the thecal sac, without significant spinal canal narrowing. The neural foramina are patent at all levels. The vertebral body heights are preserved. There is mild loss of the intervertebral disc signal at multiple levels secondary to degeneration, with minimal loss of height. Probable arterial hemangioma is seen at T1.

There is a small amount of fluid in the esophagus.


  1. Cervical spine: Degenerative changes result in moderate to marked narrowing of the right C4-C5 and C5-C6 neural foramina and mild to moderate narrowing at other levels as detailed above. There is mild indentation of the spinal cord at C5-C6 and C6-C7, otherwise without significant spinal canal narrowing.
  2. Thoracic spine: Findings most consistent with a type I spinal dural arteriovenous fistula. No definite intramedullary signal changes.


Case Challenge: Spine MRI Cases

Case Challenge

last updated: 2022-03-08 19:53:39

created: 2022-03-08 19:53:39

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