Giant Lumbar Lateral Meningocele: X-ray, CT and MRI Findings

Öz

Purpose:To present the imaging findings of an infrequent disease: giant lumbar lateral meningocele. Material and Methods: One year old baby who was presented to the neurosurgery outpatient clinic with a complaint of a mass on the lumbar area, underwent ultrasonography, abdominal CT and lumbar MRI. Results: The evaluation of all imaging findings revealed multiple bilateral lumbar lateral meningocele. The largest one was measured about 10 x 8 x 10 cm, enlarged the left neural foremen at the level of L4-5, extended to the subcutaneous fat and involved neural tissue. They were hypointense on T1 and hyperintense on T2 weighted images. Conclusion: Lateral myelomeningocele anomaly was seen infrequently and may be associated with a genetically inherited disease: lateral meningocele syndrome. For didactic purposes; ultrasonography, CT and MR imaging findings of a lumbar lateral myelomeningocele case were presented. To be aware of imaging and clinical findings of this rare disease will aid in the diagnosis and treatment of this anomaly. Key words: Lateral meningocele, Magnetic resonance imaging, Ultrasonography, Computerized tomography.

Anahtar Kelimeler

• Lateral meningocele, Magnetic resonance imaging, Ultrasonography, Computerized tomography.

Lomber Lateral Dev Meningoselli Olguda Direkt Röntgenogram, US ve MRG Bulguları

Öz

Amaç: Lomber lateral dev meningoselli olgunun görüntüleme bulgularının sunulması. Gereç ve Yöntem: Belinde şişlik nedeniyle beyin cerrahi polikliniğine baş vuran 1 yaşındaki erkek olguya meningosel ön tanısıyla ultrasonografi, alt abdomen BT tetkiki ve manyetik rezonans görüntüleme uygulandı. Sonuç: Tüm görüntüleme bulguları bir arada değerlendirildiğinde en büyüğü L4- 5 düzeyinde sol nöral foramen aracılığı ile cilt altı yağlı doku içerisine uzanan T2 A hiperintens, T1 A hipointens düzgün konturlu içerisinde nöral elemanlara ait lineer sinyal intensitelerinin izlendiği 10 x 8 x 10 cm boyutlarında, çok sayıda iki taraflı lomber lateral meningosel kesesi saptandı. Tartışma: Lateral myelomeningosel anomalisi çok nadir izlenen bir hastalık olup genetik geçişli lateral meningosel sendromu ile ilişkili olabilir. Bu nedenle lomber myelomeningosel olgusunun ultrasonografi, direkt röntgenogram, BT ve MRG bulgularını sunduk. Bu hastalığın radyolojik bulgularının bilinmesinin tanı ve tedavinin doğru yönlendirilmesinde etkili olacağını düşünüyoruz. Anahtar kelimeler: Lateral meningosel, Magnetik rezonans görüntüleme, Ultrasonografi, Bilgisayarlı tomografi.

Anahtar Kelimeler

• Lateral meningosel, Magnetik rezonans görüntüleme, Ultrasonografi, Bilgisayarlı tomografi.

Kaynakça

1. Barkovich AJ, Naidich TP. Congenital anomalies of the spine. In: Norman D, eds. Contemporary neuroimaging. Vol 1, Pediatric neuroimaging. 2nd ed. New York, NY: Raven 1995; 477-540.
2. Byrd SE, Darling CF, McLone DG. Developmental disorders of the pediatric spine. Radiol Clin North Am 1991; 29:711-52.
3. Karin M. Unsinn, MD, Theresa Geley, MD, Martin C. Freund, MD and Ingmar Gassner, MD. US of the spinal Cord in newborns: Spectrum of normal Findings, Variants, Congenital Anomalies, and Acquired Disease. Radiographics 2000; 20: 923- 38.
4. Naidich TP, Zimmerman RA, McLone DG, Raybaud CA, Altman NR, Braffman BH. Congenital anomalies of the spine and spinal cord. In: Atlas SW, eds. Magnetic resonance imaging of the brain and spine. 2nd ed. New York, NY: Lippincott-Raven 1996;1265-338.
5. Anderson H, Carlsson CA, Rosengren K: A radiological study of the central canal in myelomeningocele. Dev Med Child Neurol Suppl 1967; 9:96- 102.
6. Lee K, Gower DJ, MeWhorter JM et al : The role of MR imaging in the diagnosis and treatment of anterior sacral meningocele. J Neurosurg 1988; 69:628- 31.
7. Emery JL, Lendon RG: The local cord lesion in neurospinal dysraphism meningomyelosel. J Pathol 1973; 110: 83- 96.
8. Lemize RJ, Graham CB, Bectwith JB: Skin covered sacrococcygeal masses in infants and children. J Pediatr 1971; 948- 54.

9. Reis C, Carneiro E, Fonseca J, Pereira P, Vaz R, Pinto R, Capelinha AF, Lopes JM, Salgado A. Epithelioid hemangioendothelioma and multiple thoraco-lumbar lateral meningoceles: two rare pathological entities in a patient with NF-1. Neuroradiology 2005; 47:165-9.
10. Chen KM, Bird L, Barnes P, Barth R, Hudgins L. Lateral meningocele syndrome: vertical transmission and expansion of the phenotype. Am J Med Genet A 2005; 133:115-21.
11. Gripp KW, Scott CI Jr, Hughes HE et al.. Lateral meningocele syndrome: three new patients and review of the literature. Am J Med Genet 1997; 70:229-39.
12. Barkovich AJ. Congenital anomalies of the spine. In: Pediatric neuroimaging 3 rd ed. Philadelphia, PA : Lippincott Williams& Wilkins 2000; 667-68.
13. Zibis AH, Markonis A, Karantanas AH. Unusual causes of spinal foraminal widening. Eur Radiol 2000; 10:144-8.