Figure 7. (a) Sagittal spinal ultrasound showing lipoma of the filum terminale (arrow). (b) Sagittal T1 weighted MRI (same patient) demonstrates high signal lipoma (arrow). (c) Sagittal T2 weighted MRI (same patient) demonstrates lipoma of intermediate signal, and confirms that the cord is tethered, extending to level L5. (d)Sagittal line diagram showing features of lipoma of the filum terminale. The lipoma (L) tethers a low lying spinal cord (large arrow). The intradural lipoma is separated from subcutaneous fat of the back by a tissue plane (small arrows). (e) Sagittal line diagram showing features of lipomyelomeningocele in the lumbosacral region. There is a large dysraphic defect in the neural arches and a skin-covered herniated sac composed of fat that is contiguous with the subcutaneous fat (asterisks) and a low lying tethered spinal cord (arrows). ((a–c) reproduced with kind permission from Dick EA, de Bruyn R, Patel K, Owens CM. Spinal ultrasound in cloacal exstrophy. Clin Radiol 2001;56:289–94. (d,e) reproduced with kind permission from Byrd SE, Darling CF, McLone DG, Tomita T. MR imaging of the pediatric spine. Magn Reson Imaging Clin N Am 1996;4:797–833.)
