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Age: 25

Sex: Female

Indication: Endocarditis, rule out epidural abscess (unable to receive contrast)

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Case #2


Findings

  • Prominent pulsation artifact in the dorsal subarachnoid space throughout the thoracic spine without discrete intradural or extradural collection
  • Normal marrow signal and vertebral alignment
  • Normal cord signal and contour
  • No significant focal degenerative changes
  • Multiple cavitary lesions in both lungs


Diagnosis

  • CSF pulsation artifact

Sample Report

Prominent pulsation artifact in the dorsal subarachnoid space throughout the thoracic spine without discrete intradural or extradural collection. No significant mass effect on the thoracic spinal cord, which is normal in signal and contour.

No noncontrast MRI evidence of discitis/osteomyelitis.

Multiple cavitary lesions in both lungs, concerning for septic embolic disease in the setting of endocarditis. Recommend chest CT for further assessment.


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Images

CSF pulsation in the dorsal subarachnoid space in the upper and mid thoracic spine. Notice how signal loss is more pronounced on T2-weighted than T1-weighted sagittal sequences because T2-weighted sequences have longer TE. Also notice how signal perturbation is more pronounced on the axial (perpendicular to CSF flow) T1-weighted sequence than on the sagittal (parallel to CSF flow) T1-weighted sequence.



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