Abstract
Syringomyelia is a multifactorial disorder comprising fluid-filled cavitations within the spinal cord. In addition to establishing the diagnosis, neuroradiological techniques may discern the etiology and pathophysiology and thus inform treatment. While multiplanar MRI with T1- and T2-weighted sequences is the gold standard for imaging, advanced techniques such as phase-contrast MRI and cine MRI are increasingly used both in diagnosis and follow-up. This chapter provides a practical approach to syringomyelia imaging, its interpretation, and pitfalls.
Syringomyelia is rarely a primary anomaly; beyond demonstrating the size and extent of syringomyelia, imaging techniques should be directed toward identifying an underlying cause. A disturbance to normal craniospinal CSF circulation is the most common predisposition to syringomyelia formation, as, for example, occurs in hydrocephalus or Chiari type I malformation. Local disturbances of spinal CSF circulation may also result in syringomyelia, for example, following spinal cord trauma, infection, or inflammation. Spinal cord neoplasms will often be associated with “cyst” formation resulting in an appearance of syringomyelia.
Syringomyelia should therefore be considered the beginning rather than the end of a diagnostic process.
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Abbreviations
- CIM:
-
Chiari I malformation
- CIIM:
-
Chiari II malformation
- C:
-
Cervical
- CSF:
-
Cerebrospinal fluid
- CT:
-
Computed tomography
- L:
-
Lumbar
- MRI:
-
Magnetic resonance imaging
- T:
-
Thoracic
- V-P shunt:
-
Ventriculoperitoneal shunt
- US:
-
Ultrasonography
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Pavaine, J., Thompson, D. (2019). Imaging of Spinal CSF Disorders: Syringomyelia. In: Barkhof, F., Jäger, H., Thurnher, M., Rovira, À. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-68536-6_12
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