Spinal neurenteric cyst

Last revised by Sonam Vadera on 4 Jan 2022

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%).

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

These lesions can recur and hence MRI is also used for follow up.

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