Spinal neurenteric cyst
Citation, DOI & article data
Spinal neurenteric cysts are a rare type of foregut duplication cyst, accounting for ~1% of all spinal cord tumors. They are usually classified as spinal or intracranial and are associated with vertebral or CNS abnormalities respectively.
Neurenteric cysts result from incomplete resorption of the neurenteric canal.
The intraspinal cysts are usually intradural extramedullary (80-90%) 4 and ventral in location 5. They most commonly occur in the thoracic region (~40%).
- vertebral anomalies like Klippel-Feil syndrome, hemivertebra, butterfly vertebra, scoliosis, split cord and spina bifida 5,6
The cyst is seen as a well-defined hypoattenuating lesion which may show soft-tissue attenuation.
On CT myelography, the cyst does not opacify with intrathecal contrast. However, larger cysts may cause obstruction to the CSF flow; in such cases, intrathecal contrast material forms meniscus shape (meniscus sign) 5.
It is the investigation of choice and the appearance depends on the variable protein content:
- T1: variable signal intensity
- T2: variable signal intensity
Treatment and prognosis
These lesions can recur and hence MRI is also used for follow up.
- 1. Preece MT, Osborn AG, Chin SS et-al. Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol. 27 (6): 1211-6. AJNR Am J Neuroradiol (citation) - Pubmed citation
- 2. Simon JA, Olan WJ, Santi M. Intracranial neurenteric cysts: a differential diagnosis and review. Radiographics. 17 (6): 1587-93. Radiographics (citation) - Pubmed citation
- 3. Kemp SS, Towbin RB. Pediatric case of the day. Neurenteric cyst without associated vertebral anomalies. Radiographics. 1992;12 (6): 1255-7. Radiographics (citation) - Pubmed citation
- 4. Savage JJ, Casey JN, McNeill IT et-al. Neurenteric cysts of the spine. J Craniovertebr Junction Spine. 2010;1 (1): 58-63. doi:10.4103/0974-8237.65484 - Free text at pubmed - Pubmed citation
- 5. Dhruv M. Patel, Brent D. Weinberg, Michael J. Hoch. CT Myelography: Clinical Indications and Imaging Findings. (2020) RadioGraphics. 40 (2): 470-484. doi:10.1148/rg.2020190135 - Pubmed
- 6. Garg N, Sampath S, Yasha TC, Chandramouli BA, Devi BI, Kovoor JM. Is total excision of spinal neurenteric cysts possible?. (2008) British journal of neurosurgery. 22 (2): 241-51. doi:10.1080/02688690701818919 - Pubmed