PURPOSE: To evalute the usefulness of contrast-enhanced fat saturation T1-weighted imaging for the evaluationof spinal lipoma, compared with clinical symptoms and surgical findings. MATERIALS AND METHODS: Ten patients withlipomyelomeningocele, confirmed by surgery, were included in this study. In all cases, conventional spin echoT1-and T2-weighted MR imaging, and contrast-enhanced fat saturation T1-weighted imaging was performed to evaluateclinical symptoms, the position of the conus medullaris, the prescence of cord tethering, and associatedanomalies, and to compare the relative usefulness of the techniques. RESULTS: All ten patients were sufferingfrom lipomyelomeningocele without filum terminale fibrolipoma or intradural lipoma. All cases were associated withcord tethering. As associated anomalies, there were seven cases of syringomyelia without hydrocephalus oranorectal anomaly. To evaluate the position of the spinal conus and the prescence of cord tethering, conventionalT1-weighted imaging was more useful than the contrast-enhanced fat saturation equivalent. CONCLUSION: In patientswith early-stage spinal lipona, MRI is useful for evaluation of the causes and position of cord tethering andassociated anomalies Our results suggest that contrast-enhanced fat saturation T1-weighted images do not provideadditional information concerning spinal lipoma, and that for the diagnosis of this condition, conventional T1 and T2-weighted images are more useful than those obtained by contrast-enhanced fat saturation T1-weighted imaging.