Advanced MR imaging for the optimal micro neurosurgical planning in patients with the congential spinal meningeal cysts

The extramedullar meningeal cysts are congential anomalies of the spinal canal. The neurological manifestation - the syndromes of radicular pain and the dysfunctions of the pelvic organs are indicators for the neurosurgical treatment. The most complete classification of distinguish the different types of these anomalies is the Nabor's classification. The congential anomalies (malformations) are conventionally diagnosed by TC or conventional MR imaging techniques. These methods can't give a precise answer to the Nabor's classification. The new MR sequences offer the possibility to diagnose these anomalies more precisely. Purpose: to create a new MR protocol for a precise topical diagnostic of the meningeal cysts according to the contemporary embriogenetical, neurological and neurosurgical classification. Conclusions: For the optimal topographical visualisation of the congential spinal meningeal cysts MR in 3 orthogonal planes must be performed. The thin slice techniques with the specific parameters for better visualisation of the nerve roots are necessary. The thin slice, fat suppressed MR sequences are very important for the differential diagnosis of the extradural meningeal cysts from the dermoids, para- and infraspinal fat collections. They are very useful in choosing the optimal microneurosurgical way of the surgical treatment. (authors)