Monday 17 June 2024

Dural ectasia spine MRI


Sagittal MR images of spine showing multiple contiguous widening of CSF space posterior to the cord in thoracolumbar region, associated posterior scalloping of the vertebral bodies, widening of caliber of the bony spinal canal, hypo plastic posterior elements. 

Axial T2 images, STIR coronal images showing multiple lateral meningoceles in thoracolumbar region with enlarged neural foramen.

Spinal cord displaced anteriorly, flattened, compressed against anterior confines of anterior bony spinal canal.

Imaging diagnosis: dural ectasia.

Dural ectasia is widening of the dural sac, associated with herniation of nerve root sleeves out of foramina. Scalloping of the posterior vertebral body, thinning of cortex of pedicles and laminae, widening of neural foramina expected to prolonged pressure effect from the dural sac containing CSF.

Dural ectasia is very well-known with  Marfan syndrome however can also be associated with other inherited connective tissue disorders, including Ehlers-Danlos syndrome and Loeys-Dietz syndrome, type 1 neurofibromatosis, ankylosing spondylitis, Lehman syndrome.

Dural ectasia can also be associated with trauma, scoliosis.

May be asymptomatic, may present with back pain, headaches, radicular pain, leg weakness or urinary incontinence.

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