Clin Orthop Surg.  2015 Dec;7(4):515-518. 10.4055/cios.2015.7.4.515.

Unique Imaging Features of Spinal Neurenteric Cyst

• Jung HS
• Park SM
• Kim GU
• Kim MK
• Song KS

• KMID: 2360268
• DOI: http://doi.org/10.4055/cios.2015.7.4.515

Abstract

A 50-year-old male presented with acutely progressed paraplegia. His magnetic resonance imaging demonstrated two well-demarcated components with opposite signals in one cystic lesion between the T1- and T2-weighted images at the T1 spine level. The patient showed immediately improved neurological symptoms after surgical intervention and the histopathological exam was compatible with a neurenteric cyst. On operation, two different viscous drainages from the cyst were confirmed. A unique similarity of image findings was found from a review of the pertinent literature. The common findings of spinal neurenteric cyst include an isointense or mildly hyperintense signal relative to cerebrospinal fluid for both T1- and T2-weighted images. However, albeit rarer, the signals of some part of the cyst could change into brightly hyperintensity on T1-weighted images and hypointensity on T2-weighted images due to the differing sedimentation of the more viscous contents in the cyst.

Keyword

Spinal cord; Neoplasm; Neuroenteric cyst; Magnetic resonance imaging

MeSH Terms

Diagnosis, Differential
Humans
Magnetic Resonance Imaging
Male
Middle Aged
*Neural Tube Defects/diagnosis/physiopathology/surgery
*Spinal Cord/pathology/surgery
*Spinal Cord Diseases/diagnosis/physiopathology/surgery

Figure

• 

  Fig. 1 Axial T2-weighted magnetic resonance imaging scan at the T1 spinal level showing a hypointense mass surrounded by an isointense signal severely compressing the spinal cord on the left side.

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  Fig. 2 Sagittal T1-weighted (A), T2-weighted (B), and T1-weighted enhancement (C) images demonstrating a well demarcated heterogeneous mass (about 2 × 1.2 × 2.1 cm) containing two components with opposite signals between the T1- and T2-weighted images without enhancement. The supernatant lesion showed a mild hyperintensity on T1-weighted and isointensity on T2-weighted images. The infranatant lesion showed a bright hyperintensity on T1-weighted and hypointensity on T2-weighted images.

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  Fig. 3 Intraoperative photograph after the first drainage of clear fluid. Note the yellow-green color and higher viscosity of the fluid.

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  Fig. 4 The histopathological examination of the neurenteric cystic wall composed of columnar epithelium with goblet cells (H&E, ×200).

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