case_images: PMC3927088_01
case_images: Diagnostic imaging. (a) Coronal and sagittal T1 with gadolinium and axial T2 MRI demonstrating mild dilatation of the lateral ventricles, left atrial diverticulum, and inferior displacement of the cerebellar tonsils (McRae's line in yellow). (b) MR myelography of the thoraco-lumbar and cervico-thoracic spine with 3D reconstruction demonstrating lumbar DE (triangles), root sleeve cysts (arrows), and paraspinal CSF bands (arrowheads). (c) MR myelography of the cervico-thoracic spine demonstrating root sleeve cysts (arrows) and extravasation of CSF with paraspinal CSF band (arrowheads)
case_images: SNI-5-8-g001.jpg
case_images: PMC3927088_01_SNI-5-8-g001.jpg
case_images: F1
case_images: Imaging of the brain demonstrated mild dilatation of the lateral ventricles with crowding of the gyri, and inferior displacement of the posterior fossa structures, with the cerebellar tonsils extended below the level of the foramen magnum [Figure 1a]. An atrial diverticulum was noted as a medial out-pouching of the trigone of the left lateral ventricle [Figure 1a]. MR myelography and spinal MRI [Figure 1b and c]. Multiple sacral and thoracic root sleeve cysts and paraspinal thin bands of CSF were observed in the left thoracic region, consistent with CSF extravasation [Figure 1b and c].
case_images: Validation of radiographic metrics for DE. (a) Validation of Oosterho's method, with positive findings for DE. (b) Validation of Ahn's method, with positive findings for DE. (c) Validation of Soylen's method, with positive findings for DE. DSD: Disk space diameter; VBD: Vertebral body diameter; AVG: Average; TW*SW: Transverse width *sagittal width
case_images: SNI-5-8-g002.jpg
case_images: PMC3927088_01_SNI-5-8-g002.jpg
case_images: F2
case_images: Oosterhof's, Ahn's, and Soylen's criteria [Figure 2]. Of note, the patient also had a significant scoliotic deformity, which may have introduced a degree of error into applying these metrics.