High-resolution constructive interference in steady-state imaging in tethered cord syndrome: technical note.
BACKGROUND
Differentiation between nerve roots and the tethered filum terminale in magnetic resonance images remains challenging. It is, however, crucial to select patients for surgical intervention.


METHODS
In 1 patient with progressive and 2 patients with stable clinical signs of tethered cord syndrome (TCS), images reconstructed from a 3D constructive interference in steady-state (CISS) sequence were compared with those obtained from a regular T2-weighted fast spin echo sequence.


RESULTS
Nerve roots of the cauda equina were suppressed, whereas visualization of the filum terminale was much improved in high-resolution CISS sequences. In addition, the level of adhesion of the filum could be localized in relation to elements of the spinal cord. The imaging results were confirmed during surgery and the patient improved considerably after the intervention. The advantages of CISS were also apparent in 2 other patients who are still being observed.


CONCLUSIONS
Constructive interference in steady-state imaging should be considered in the presurgical routine for patients with TCS.
Rosahl
Steffen K
SK
Department of Neurosurgery, Albert-Ludwigs-University, D-79106 Freiburg, Germany. rosahl@t-online.de
Kassem
Osama
O
Piepgras
Uwe
U
Hellwig
Dieter
D
Samii
Madjid
M
D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000592:standards*; D009436:Neural Tube Defects / Q000473:pathology*; D010347:Patient Care Planning; D018579:Patient Selection; D012680:Sensitivity and Specificity; D013126:Spinal Nerve Roots / Q000033:anatomy & histology* / Q000473:pathology*