Article Figures & Data
Figures
- 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.
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.
Tables
- TABLE 1:
MR Characteristics of five patients with incidental finding of an ecchordosis physaliphora
Patient/Sex/Age (y) Size (mm) Form Signal Intensity Compared with Brain Contrast Enhancement T2 Signal-Intensity Changes at Clivus Stalk Visible T1 T2 1/M/71 6 × 5 × 13 Oval to lobulated Low High No Yes Yes 2/M/38 5 × 4 × 5 Round Low High No No No 3/M/74 6 × 5 × 5 Round Low High No Yes Yes 4/F/55 4 × 3 × 5 Oval Low High No Yes No 5/M/10 3 × 2 × 2 Oval Low High No Yes Yes - TABLE 2:
Reported cases with prepontine ecchordosis physaliphora and intradural chordoma including MRI
Author and Year Reported Diagnosis Symptoms Size (cm) Signal Intensity Contrast Enhancement T1 T2 Macdonald et al, 1990 (8) Ecchordosis CSF fistula 1.5* Low High NA Watanabe et al, 1994 (19) Ecchordosis None NA Low High No Akimoto et al, 1996 (15) Ecchordosis Headache NA Low High No Toda et al, 1998 (5) Ecchordosis Headache 1.5 Low High No Rodriguez et al, 1999 (4) Ecchordosis Dizziness 3 Low High No Cha et al, 2002 (6) Ecchordosis Headache, dizziness 1.5 Low High No Mapstone et al, 1983 (16) Intradural chordoma Cranial nerve V–VII palsy 2.5* Low High Yes Yuhi et al, 1986 (20) Intradural chordoma Cranial nerve VII–X palsy NA Low High Yes Tashiro et al, 1994 (17) Intradural chordoma Tetraparesis, cranial nerve V and VII–XII palsy 3.5 Low High Yes Nishigaya et al, 1998 (12) Intradural chordoma Ataxia, dysarthria, nystagmus 4 Low High Yes Note.—NA indicates not available.
* Estimated from pictures.
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