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[Intraspinal lipoma in an infant: a case report of MRI study]
M Nagane1, T Eguchi, K Takayanagi
1Department of Neurosurgery, Kameda General Hospital.
Insights
This study describes a case of intraspinal lipoma in an infant, highlighting the diagnostic capabilities of MRI for early detection and surgical planning. Advanced imaging techniques aid in diagnosing spinal lipoma in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Spinal Cord Imaging
Background:
- Intraspinal lipomas are congenital tumors often associated with spinal dysraphism.
- Early diagnosis is crucial for preventing neurological deficits in infants.
Observation:
- A 6-month-old boy presented with lumbosacral subcutaneous lipoma and occult spinal dysraphism.
- CT scan showed a low-density lesion, while MRI revealed a high signal intensity intraspinal lipoma attached to the spinal cord.
Findings:
- MRI, particularly sagittal views on T1-weighted spin echo images, provided high contrast and precise anatomical detail of the intraspinal lipoma.
- The lipoma was extramedullary with connections to epidural adipose tissue, without evidence of tethered cord.
Implications:
- MRI is a valuable non-invasive tool for accurate and early diagnosis of spinal lipoma in infants.
- Timely diagnosis facilitates appropriate surgical intervention, potentially improving patient outcomes.
Abstract:
A 6-month-old boy having intraspinal lipoma with lumbosacral subcutaneous lipoma and occult spinal dysraphism is described. CT scan and magnetic resonance imaging (MRI) are demonstrated. On admission, the patient showed no neurological deficits. Lumbosacral hemangioma and subcutaneous lipoma were noticed on physical examination. A plain spinal roentogenogram revealed occult spinal dysraphism extending from L 4 level down to the sacral region. A plain CT scan disclosed a round-shaped low density area surrounded by a relatively high density area corresponding to the neural tissue in the spinal canal. MRI (1.5-T superconducting system) with sagittal views clearly showed an oval-shaped high signal intensity (SI) area-an intraspinal lipoma-with the neural tissue running longitudinally within and on its surface. The lipoma appeared to be attached to the spinal cord at L 1/2 level. On operation, we found an extramedullary lipoma which had a certain connection to the sacral epidural adipose tissue with an opening of the dural sac, as far as the subcutaneous lipoma. Tethered cord and thickened filum terminale were not identified. Generally, lipoma is demonstrated as a low density area of approximately -90 H.U. on a CT scan. In MRI, we can obtain a high contrast between the lipoma, the spinal cord, and the cerebrospinal fluid, since they are shown as a high, an intermediate, and a low SI area respectively, on T1-weighted spin echo images. Furthermore, sagittal section of MRI is regarded as a potent diagnostic modality to get the precise anatomy of the spinal cord lesion. These short spin echo images can be taken in a relatively brief time. It is a great advantage for patients with spinal lipoma, who are usually infants. MRI is considered to be a quite useful modality to diagnose spinal lipoma, and is able to lead to an early diagnosis non-invasively and accurately, facilitating appropriate surgical treatment.(ABSTRACT TRUNCATED AT 250 WORDS)