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MRI, Thoracolumbar Spine (lesion found)

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Please Advice.
I'm a 23 yrs old girl after i get to know my MRI result I'm so lost and scared.



Last week i went for MRI, Thoracolumbar Spine.


the report result was:

Spinal alignment is normally maintained. Marrow returns uniform normal signal.

7.2 / 2.2 / 2.2 cm elliptical, extramedullary lesion is noted in spinal canal extending from the level of T12 to L2. The lesion has uniform fluid content (low signal on T1 and high signal on T2). No solid component or abnormal enhancement seen post contrast. The lesion is located to the right side of spinal canal. There is scalloping of posterior aspect of vertebral body of L1. The conus and adjacent cauda equin roots are draped around the lesion and displaced to left. The right pedicle of L1 is absent.

Intervertebral disk return normal signal and maintain their heights. No significant disk lesion seen at any level in thoracic or lumbar spine.

Spinal cord ends at L1 level.


Impression :

Extramedullary lesion extending from T12 to L2 level with scalloping of L1 vertebral body. Mass effect on conus and cauda equina roots. This most likely represents an arachanoid cyst.
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replied January 11th, 2012
Especially eHealthy
Paulynnz,

You do not say what symptoms you were having, that prompted getting an MRI.

But, an arachnoid cyst is a benign cyst arising from the arachnoid membrane. The arachnoid membrane is one of the layers of the dura, which covers the brain and spinal cord.

Spinal arachnoid cysts are generally misdiagnosed, because symptoms are often nonspecific. Often, the cysts are an incidental finding on magnetic resonance imaging (MRI). Usually, arachnoid cysts are asymptomatic; this is true even of cysts that are quite large. Controversy surrounds the treatment of arachnoid cysts.

Some clinicians advocate treating only patients with symptomatic cysts, whereas others believe that even asymptomatic cysts should be decompressed to avoid future complications. The most effective surgical treatment appears to be excision of the outer cyst membrane and cystoperitoneal shunting. Cysts that cause symptoms from cord compression are best evaluated with MRI; they should be surgically excised, if possible.


This is why you should discuss the findings with the physician who ordered the test. Treatment has to be based on your history, symptoms, and physical exam. Only your physician can discuss treatment options with you.

Good luck.
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replied January 12th, 2012
Hi Gaelic,

Thks for d advice... Actually i only suffer for lower back pain as the pain becoming more regular so the A&E doc advice me to go for a mri scan... There are no medical history on my family that has got this kinda situtation... May i know what actually causes this to happen?
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replied January 12th, 2012
Especially eHealthy
Paulynnz,

The exact cause of arachnoid cysts is not known. Researchers believe that most cases of arachnoid cysts are developmental malformations that arise from the unexplained splitting or tearing of the arachnoid membrane.

Arachnoid cysts can also occur secondary to other disorders such as Marfan syndrome, arachnoiditis, or agenesis of the corpus callosum.


So, most of them just occur for unknown reasons. Your lower back pain could be coming from the mass effect of the cyst, and also the fact that the right pedicle of L1 is absent. It could be that due to the pressure from the cyst, the pedicle has been destroyed. But, further studies with a CT scan may be necessary. The MRI is great for soft tissues, but does not look at the architecture of bone very well.


Speak with your physician at length about this problem. Good luck.
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