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Visibility of the central canal on MRI
M C Petit-Lacour1, P Lasjaunias, C Iffenecker
1Service de Neuroradiologie Pr Lasjaunias, Hôpital de Bicêtre, Faculté Paris Sud, Kremlin-Bicêtre, France.
Abstract:
The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persist partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral 1/3 and dorsal 2/3 of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up.
Insights
A persistent central canal in the spinal cord, identified via MRI, is a normal anatomical variant. This finding, often overlooked, does not correlate with clinical symptoms or predispose to conditions like syringomyelia.
Area of Science:
- Neurology
- Radiology
- Anatomy
Background:
- The central canal of the spinal cord is a congenital structure that typically obliterates with age.
- Previous cadaver studies suggested potential persistence, but this entity remained undescribed on Magnetic Resonance Imaging (MRI).
Purpose of the Study:
- To describe the MRI characteristics of a persistent central canal.
- To determine if this finding represents a normal variant or a pathological condition.
Main Methods:
- Retrospective review of 794 spinal cord MRI studies.
- Identification and analysis of intramedullary cavities consistent with a persistent central canal.
- Correlation of imaging findings with clinical data and predisposing anatomical factors.
Main Results:
- 12 patients (aged 14-65 years) exhibited an intramedullary cavity, predominantly thoracic (69%).
- Cavity morphology was typically filiform or fusiform (3-4 mm diameter) with regular contours, located ventrally/dorsally or centrally in the lumbar region.
- No association was found between these cavities and clinical symptoms, Chiari malformation, or dysraphism, differentiating them from syringomyelia.
Conclusions:
- The identified intramedullary cavities are consistent with a persistent central canal, representing a normal variant of spinal cord anatomy.
- Recognizing this finding as normal is crucial to prevent misdiagnosis, unnecessary treatment, and unwarranted follow-up.