superficial siderosis mri arachnoiditis arachmoid cyst radedasia


Superficial Siderosis MRI Cord and Spine: Complications and Associations.

Superficial Siderosis can affect the cord, nerve roots and the CSF space in the thecal sac.

Here is what to look for and where to look to not miss this diagnosis.

Hemosiderin deposition on Nerve Roots can result in arachnoiditis.

  1. Clumping and abnormal distribution of nerve roots.
  2. The normal symmetric distribution of nerve roots is lost and there is asymmetry in their distribution. (2nd and 3rd images below asymmetric distribution of nerve roots).
  3. The nerves can also stick to each other resulting in the appearance of an enlarged nerve root (Green arrow).

superficial siderosis mri cord spine nerve root radedasia

  1. Enhancement of nerve roots can occur but is not always present.
  2. Enhancement is secondary to inflammatory changes induced by the hemosiderin deposition.
  3. Giving contrast is not essential to making a diagnosis of arachnoiditis in superficial siderosis.

superficial siderosis mri arachnoiditis enhancement radedasia

  1. Superficial siderosis of the cord  (Pink arrow) can result in cord oedema (Blue arrow).
  2. WHY IS THAT? Hemosiderin lining of the cord results in abnormal movement of CSF through the cord. This can result in cord oedema with increased T2 signal in the cord.

superficial siderosis mri cord oedema radedasia

  1. Extra dural arachnoid cysts (Green arrow) can be associated with and result in superficial siderosis (Pink arrow).
  2. The mechanism is thought to be from a tear in the dura resulting in low grade chronic bleeding resulting in siderosis and formation of an extra dural arachnoid cyst due to a leak from the dural tear.

superficial siderosis mri arachnoid cyst extradural radedasia

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superficial siderosis mri cord spine radedasia

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