MRI - MRI lumbar spine
Sagittal T1
Sagittal T2
Sagittal T1 C+ fat sat
Axial T2
Axial T1 C+ fat sat
At what level should you measure the filum thickness and what is the upper limit of normal?
L5/S1. The filum should be less than 2mm in thickness.
How would this abnormality in this patient be managed?
It would be ignored, provided there were no symptoms suggestive of tethered cord. If there were then treatment is controversial and depends on the severity and specificity of the symptoms.
MRI confirms the presence of fatty tissue (high T1, high T2, suppresses on fat saturated sequences) extending from the conus to at least L5. The conus is located at L1/2 and is normal in appearance.
Degenerative change is noted once more.