0:01

So let's review some normal anatomic variants

0:03

that we might see at neonatal spine ultrasound.

0:06

So the first one is by far

0:07

and away the most common normal finding that we see all day,

0:10

every day when we image these patients.

0:12

And that is a filer cyst.

0:14

So that's just a kind of teardrop, uh, fluid structure

0:17

that extends from the tip of the conus meis.

0:21

This is a totally normal structure that we see all the time.

0:25

It is at the inferior aspect of the phylum terminality

0:28

and this purple arrow is showing it

0:30

to you here on the sagittal plane.

0:32

And here is what it looks like in the,

0:33

in the transverse plane.

0:35

Otherwise, the phylum terminality totally looks normal.

0:38

Again, on cinematic images,

0:39

we would see nice normal movements of the cord

0:42

and nerve rootless of the Cato equina.

0:44

This patient for other reasons, went on to MRI,

0:47

but it looks exactly the same on spine MRI,

0:50

just a tear droppped little shaped fluid collection at the

0:54

end of the phylum terminality.

0:56

So an a normal variant filer cyst.

1:00

The other normal variant you're gonna see pretty frequently

1:03

is a ventricular terminis.

1:05

So this is sort of like my dumb brain thinks of this

1:08

as a filer cyst that just happens

1:10

to be in the inferior aspect of the spinal cord.

1:13

So, um, this is also called a terminal ventricle.

1:16

It is just a transiently dilated central append canal.

1:20

At the inferior aspect of the cord, there are measurements

1:24

that I always have to look up,

1:25

but here they are for you to remember.

1:27

Um, it's allowed to be up to four millimeters in width

1:30

and it's allowed to be up to two centimeters in length

1:33

and still be considered normal.

1:35

These typically spontaneously resolve within

1:37

the first few weeks of life.

1:38

It's a transient, normal variant finding we see at imaging.

1:43

Now, if you have what looks like a,

1:45

a dilated central penal canal,

1:47

but it's not at the lumbar spine level,

1:49

then it just might be transient dilatation

1:52

of the central canal.

1:53

So this is the same thing as a terminal ventricle.

1:55

It's just not involving the lumbar spine.

1:57

It's located more superior.

2:00

The good news is you don't have other numbers.

2:02

You have to remember the width

2:04

of the central canal is still four millimeters or smaller

2:07

or greater than, or less than two centimeters in length.

2:10

So just like the terminal ventricle located at the lumbar

2:14

spine cord level, this is just located anywhere else in the,

2:17

in the spinal cord.

2:19

It's another normal variant transient finding that we see

2:22

that will resolve within the first few weeks of life.

2:25

Typically, another normal variant

2:28

that you might see is prominent epidural fat.

2:31

So, uh, this can be located at the distal aspect of the,

2:35

uh, spinal canal.

2:36

It might be located ventrally, it might be located,

2:39

uh, anteriorly.

2:41

Um, this is considered a normal variant

2:43

unless it causes compressive symptoms.

2:45

So, um, this is on the upper image.

2:48

You see this is a, a panoramic view

2:50

of the spine showing you increased genic material in the

2:54

central spinal canal, um, in the epidural space.

2:57

But the conus, meis

2:59

Superiorly, the nerve rootlet of the coquina

3:01

and the phylum terminality all look normal.

3:04

This patient underwent, uh, MRI just to be sure.

3:07

Um, and you can see on this T one weighted image,

3:10

of course fat is going to be T one bright in this image.

3:13

This is just prominent epidural fat in this infant.