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Research ArticleHead and Neck Imaging

Retroclival Ecchordosis Physaliphora: MR Imaging and Review of the Literature

Florian Mehnert, Rudi Beschorner, Wilhelm Küker, Ulrich Hahn and Thomas Nägele
American Journal of Neuroradiology November 2004, 25 (10) 1851-1855;
Florian Mehnert
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Rudi Beschorner
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Wilhelm Küker
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Ulrich Hahn
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Thomas Nägele
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    Fig 1.

    Patient with known cavernoma in the medulla oblongata.

    A, Sagittal T2-weighted image shows an incidental ecchordosis physaliphora at the dorsal wall of the clivus.

    B, Intradurally, this is best delineated with a sagittal CISS sequence (3D, 1 mm, TR/TE of 12.06/6.03, flip angle of 70°).

    C, Transverse 3-mm T2-weighted image shows hyperintense changes in the dorsal clivus that have a broad connection to the intradural part.

    D, No enhancement is seen on this 3-mm contrast-enhanced T1-weighted image.

  • Fig 2.
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    Fig 2.

    Patient with multiple myelitic lesions.

    A and B, Sagittal and transverse T2-weighted 3-mm images incidentally show a round, retroclival ecchordosis physaliphora being spared in the dark signal intensity of CSF-related pulsation artifacts.

    C, T1-weighted 5-mm image does not show this finding because of the similar signal intensity compared with that of CSF.

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    TABLE 1:

    MR Characteristics of five patients with incidental finding of an ecchordosis physaliphora

    Patient/Sex/Age (y)Size (mm)FormSignal Intensity Compared with BrainContrast EnhancementT2 Signal-Intensity Changes at ClivusStalk Visible
    T1T2
    1/M/716 × 5 × 13Oval to lobulatedLowHighNoYesYes
    2/M/385 × 4 × 5RoundLowHighNoNoNo
    3/M/746 × 5 × 5RoundLowHighNoYesYes
    4/F/554 × 3 × 5OvalLowHighNoYesNo
    5/M/103 × 2 × 2OvalLowHighNoYesYes
    • View popup
    TABLE 2:

    Reported cases with prepontine ecchordosis physaliphora and intradural chordoma including MRI

    Author and YearReported DiagnosisSymptomsSize (cm)Signal IntensityContrast Enhancement
    T1T2
    Macdonald et al, 1990 (8)EcchordosisCSF fistula1.5*LowHighNA
    Watanabe et al, 1994 (19)EcchordosisNoneNALowHighNo
    Akimoto et al, 1996 (15)EcchordosisHeadacheNALowHighNo
    Toda et al, 1998 (5)EcchordosisHeadache1.5LowHighNo
    Rodriguez et al, 1999 (4)EcchordosisDizziness3LowHighNo
    Cha et al, 2002 (6)EcchordosisHeadache, dizziness1.5LowHighNo
    Mapstone et al, 1983 (16)Intradural chordomaCranial nerve V–VII palsy2.5*LowHighYes
    Yuhi et al, 1986 (20)Intradural chordomaCranial nerve VII–X palsyNALowHighYes
    Tashiro et al, 1994 (17)Intradural chordomaTetraparesis, cranial nerve V and VII–XII palsy3.5LowHighYes
    Nishigaya et al, 1998 (12)Intradural chordomaAtaxia, dysarthria, nystagmus4LowHighYes
    • Note.—NA indicates not available.

    • * Estimated from pictures.

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American Journal of Neuroradiology: 25 (10)
American Journal of Neuroradiology
Vol. 25, Issue 10
1 Nov 2004
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Cite this article
Florian Mehnert, Rudi Beschorner, Wilhelm Küker, Ulrich Hahn, Thomas Nägele
Retroclival Ecchordosis Physaliphora: MR Imaging and Review of the Literature
American Journal of Neuroradiology Nov 2004, 25 (10) 1851-1855;

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Retroclival Ecchordosis Physaliphora: MR Imaging and Review of the Literature
Florian Mehnert, Rudi Beschorner, Wilhelm Küker, Ulrich Hahn, Thomas Nägele
American Journal of Neuroradiology Nov 2004, 25 (10) 1851-1855;
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