Öz
Ventriculus terminalis or the fifth ventricle is a space full with CSF which is coated by normal ependyma cells in conus medullaris of medulla spinalis and observed rarely in adults. In the present case, findings obtained by magnetic resonance (MR) imaging associated with cystic dilatation of ventriculus terminalis were identified in an adult case. A 36 years old female patient referred by low back pain and thoracolumbar region images obtained by routin MR sequences were analyzed. A cystic dilatation with dimensions of 33x12 mm which is isointense with CSF was detected in the center of medulla spinalis at conus medullaris level in all MR sequences. Signal intensity of medulla spinalis was normal. No septation existed in the cyst detected. There was not any canal dilatation and additional spinal abnormality in canalis centralis, proximal side of medulla spinalis. Ventriculus terminalis which is identified as an ependymal space in conus medullaris rarely is observed coincidentally in MR images. Considering intensity of the imaging is useful to differantiate ventriculus terminalis from other cystic tumors located on the same site. Ventriculus terminalis generally progresses asymptomatically and treatment method is determined by clinical findings and whether the cyst is drained. MR imaging is quite important for diagnosis and follow-up of such variations
Anahtar Kelimeler
Ventriculus terminalis variation cystic dilatation conus medullaris magnetic resonance imaging
Kaynakça
- Kriss VM, Kriss TC and Babcock DS. The ventriculus terminalis of the spinal cord in the neonate: a normal variant on sonograph. AJR Am J Roentgenol 1995;165:1491-3.
- (http://www.ncbi.nlm.nih.gov/pubmed/7484594)
- Kriss VM, Kriss TC and Coleman RC. Sonographic appearance of the ventriculus terminalis cyst in the neonatal spinal cord. J Ultrasound Med 2000;19(3):207-9.
- (http://www.ncbi.nlm.nih.gov/pubmed/10709837)
- Liccardo G, Ruggeri F, Cerchio LD, Floris R and Lunardi P. Fifth ventricle: an unusual cystic lesion of the conus medullaris. Spinal Cord 2005;43:381-4. (http://www.ncbi. nlm.nih.gov/pubmed/15655569)
- Coleman LT, Zimmerman RA, Rorke LB. Ventriculus terminalis of the conus medullaris: MR findings in children. AJNR Am J Neuroradiol 1995;16:1421–6. (http://www. ncbi.nlm.nih.gov/pubmed/7484626)
- Demiryurek D, Bayramoglu A, Aydingoz U, Erbil KM, Bayraktar B. Magnetic resonance imaging determination of the ventriculus terminalis. Neurosciences 2003;8(4):241- 3. (http://www.ncbi.nlm.nih.gov/pubmed/23648888)
- Unsinn KM, Mader R, Gassner I, Kreczy A, Freund MC. Sonography of the ventriculus terminalis in newborns. AJNR Am J Neuroradiol 1996a;17:1003-4.
- (http://www.ncbi.nlm.nih.gov/pubmed/8733982)
- Unsinn KM, Mader R, Gassner I, Kreczy A. Ventriculus terminalis of the spinal cord in the neonate: a normal variant on sonography. AJR Am J Roentgenol 1996b;167:1341. (http://www.ncbi.nlm.nih.gov/pubmed/8911212)
- Suh SH, Chung T, Lee S, Cho Y,Kim KS. Ventriculus Terminalis in Adults: Unusual Magnetic Resonance Imaging Features and Review of the Literature. Korean J Radiol 2012;13(5):557-63. (http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3435852/)
- Dellured R, Server A, Berg-Johnsen J. MR imaging of ventriculus terminalis of the conus medullaris. A report of two operated patients and a review of the literature. Acta Radiol 2003;44(4):444-6. (http://www.ncbi.nlm.nih.gov/ pubmed/12846697)
- Ganau M, Talacchi A, Cecchi PC, Ghimenton C, Gerosa M, Faccioli F. Cystic dilation of the ventriculus terminalis. J Neurosurg Spine 2012 ;17(1):86-92. (http://www.ncbi. nlm.nih.gov/pubmed/22559279)
Öz
Ventriculus terminalis ya da 5. ventrikül, medulla spinalis'de conus medullaris içinde normal epandim hücreleri ile kaplı, yetişkinlerde nadir görülen ve içerisi BOS ile dolu bir boşluktur. Bu sunumda bel ağrısı ile gelen yetişkin bir vakada ventriculus terminalis'in kistik dilatasyonu ile ilgili manyetik rezonans görüntülerinden (MRG) elde edilen bulgular tanımlanmıştır. Bel ağrısı şikayeti ile başvuran 36 yaşındaki kadın hastanın rutin MRG sekansları kullanılarak elde edilen torakolumbar bölge görüntüleri incelendi. Conus medullaris seviyesinde (T11-12) medulla spinalis'in santralinde 33x12 mm büyüklüğünde, tüm MRG sekanslarında BOS ile izointens kistik genişleme saptandı. Medulla spinalis'in sinyal intensitesinin doğal olduğu gözlendi. Tespit edilen kist içerisinde septasyon yoktu. Medulla spinalis'in proksimal kısmında canalis centralis içerisinde kanal genişlemesi ve ilave spinal anomali olmadığı gözlendi. Conus medullaris içerisindeki epandimal boşluk olarak da tanımlanan ve nadir görülen ventriculus terminalis'e torakolumbar MR görüntülerinde tesadüfen rastlanmaktadır. Aynı bölgede yerleşen kistik tümörlerden ayrılması için görüntü yoğunluğunun bilinmesinde fayda vardır. Genellikle asemptomatik olup tedavi yöntemi klinik bulgulara ve kistin drene olup olmadığına göre belirlenir. Bu tür varyasyonların tanı ve izleminde MRG oldukça önemlidir.
Anahtar Kelimeler
Ventriculus terminalis varyasyon kistik dilatasyon conus medullaris manyetik rezonans görüntüleme
Kaynakça
- Kriss VM, Kriss TC and Babcock DS. The ventriculus terminalis of the spinal cord in the neonate: a normal variant on sonograph. AJR Am J Roentgenol 1995;165:1491-3.
- (http://www.ncbi.nlm.nih.gov/pubmed/7484594)
- Kriss VM, Kriss TC and Coleman RC. Sonographic appearance of the ventriculus terminalis cyst in the neonatal spinal cord. J Ultrasound Med 2000;19(3):207-9.
- (http://www.ncbi.nlm.nih.gov/pubmed/10709837)
- Liccardo G, Ruggeri F, Cerchio LD, Floris R and Lunardi P. Fifth ventricle: an unusual cystic lesion of the conus medullaris. Spinal Cord 2005;43:381-4. (http://www.ncbi. nlm.nih.gov/pubmed/15655569)
- Coleman LT, Zimmerman RA, Rorke LB. Ventriculus terminalis of the conus medullaris: MR findings in children. AJNR Am J Neuroradiol 1995;16:1421–6. (http://www. ncbi.nlm.nih.gov/pubmed/7484626)
- Demiryurek D, Bayramoglu A, Aydingoz U, Erbil KM, Bayraktar B. Magnetic resonance imaging determination of the ventriculus terminalis. Neurosciences 2003;8(4):241- 3. (http://www.ncbi.nlm.nih.gov/pubmed/23648888)
- Unsinn KM, Mader R, Gassner I, Kreczy A, Freund MC. Sonography of the ventriculus terminalis in newborns. AJNR Am J Neuroradiol 1996a;17:1003-4.
- (http://www.ncbi.nlm.nih.gov/pubmed/8733982)
- Unsinn KM, Mader R, Gassner I, Kreczy A. Ventriculus terminalis of the spinal cord in the neonate: a normal variant on sonography. AJR Am J Roentgenol 1996b;167:1341. (http://www.ncbi.nlm.nih.gov/pubmed/8911212)
- Suh SH, Chung T, Lee S, Cho Y,Kim KS. Ventriculus Terminalis in Adults: Unusual Magnetic Resonance Imaging Features and Review of the Literature. Korean J Radiol 2012;13(5):557-63. (http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3435852/)
- Dellured R, Server A, Berg-Johnsen J. MR imaging of ventriculus terminalis of the conus medullaris. A report of two operated patients and a review of the literature. Acta Radiol 2003;44(4):444-6. (http://www.ncbi.nlm.nih.gov/ pubmed/12846697)
- Ganau M, Talacchi A, Cecchi PC, Ghimenton C, Gerosa M, Faccioli F. Cystic dilation of the ventriculus terminalis. J Neurosurg Spine 2012 ;17(1):86-92. (http://www.ncbi. nlm.nih.gov/pubmed/22559279)
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Diş Hekimliği |
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2015 |
| Gönderilme Tarihi | 19 Aralık 2014 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 22 Sayı: 2 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.