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Ecchordosis physaliphora: typical and atypical radiologic features.
Hun Ho Park1, Kyu-Sung Lee1, Sung Jun Ahn2
1Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University Health System, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea.
Neurosurgical Review
|May 22, 2016
Summary
Ecchordosis physaliphora (EP), a notochordal remnant, presents distinct imaging features on MRI and CT that aid in differentiating it from clival chordoma. Accurate diagnosis is crucial for appropriate treatment planning due to differing prognoses.
Area of Science:
- Radiology
- Neuropathology
- Oncology
Background:
- Ecchordosis physaliphora (EP) is a rare notochordal remnant found on the clivus, often mistaken for clival chordoma.
- Distinguishing EP from clival chordoma is critical due to their vastly different prognoses and treatment strategies.
Purpose of the Study:
- To delineate the typical and atypical imaging characteristics of Ecchordosis physaliphora (EP) using MRI and CT.
- To aid in differentiating EP from clival chordoma, improving diagnostic accuracy.
Main Methods:
- Retrospective review of MRI and CT studies in 41 patients with suspected clival chordoma.
- Analysis of lesion characteristics including signal intensity, enhancement patterns, and presence of specific features like T2-hypointense pedicle or rim.
Main Results:
- Eight patients (19.5%) were diagnosed with EP, showing well-circumscribed, homogenous lesions.
- Typical EP featured a T2-hypointense pedicle (62.5%), while atypical EP had a T2-hypointense rim (37.5%).
- Lesions were stable in size over a mean follow-up of 3.6 years.
Conclusions:
- EP exhibits characteristic imaging features on MRI and CT that allow differentiation from clival chordoma.
- Accurate identification of EP is essential for avoiding unnecessary aggressive treatment and ensuring proper management.
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