I had a full spine MRI and a CINE MRI. Good news, no syrinx. And per the NS, there is no need for concern on the "borderline" position of the tonsils. (note - prior MRI said 5mm) I would just like an opinion here before I can truly relax. Note that the CINE MRI was without contrast and lasted less than 15 minutes.
Preliminary sagittal T2 weighted image demonstrates the right cerebellar tonsil proximally 4mm below the foramen magnum, the left slightly less. Several millimeters of cerebrospinal flid signal are present ventral to the cervicomedullary junction. Tube spinal fluid signal ispresent dorsal to the tonsils in near midline at the foramen magnum. There is no basilar impression. The clivus measures approximately 4cm in length in the basioccipit approximately 3.4 cm, the lateral relatively short dimension. Twining's line measures 8.5 cm, a relatively short dimension from the tuberculum sella to the internal occipital protuberance at the torcula. The transverse dimension at the transverse-sigmoid junction is approximately 11.6 cm out however, demonstrating a relatively wide posterior fossa.
The ventricles are normal in size and position. No stones of brain signal abnormality are detected. Multiple foci are present in cerebral hemisphere white matter, nonspecific in appearance. None are seen in the brainstem or posterior fossa. Pituitary fossa and optic nerve sheaths are unremarkable. No major arterial or venoocclusive change is noted.
Cine MRI flow study demonstrates CSF signal pulsation ventral to the cervicomedullary junction, but none dorsal to the tonsils at the opisthion-c1 region.
Impression:
1. Borderline position of the cerebellar tonsils without definite crowding, and with relatively short basiocciput. Nonspecific white matter changes may be seen with ischemia, post inflammation, demyelination.
2. CSF flow signal ventral to the cervicomedullary junction, but none dorsal to the tonsils at the opisthion.
End of report....
The three spine MRI reports are too lengthy, and probably not important enough to provide in detail. Basically, I have degenerative changes in both the cervical and lumbar areas, but without spinal cord impingement. The thoracic spine was normal except for a small root sleeve cyst at T11-12 which was not even mentioned in the impressions, so must be insignificant.
I am not concerned about the nonspecific white matter changes. I am looking for confirmation that this doesn't sound like CM.
Thank you for any feedback you are willing to provide.