Posttraumatic syringomyelia: volumetric phantom and patient studies using MR imaging

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Posttraumatic syringomyelia (PTS) is a complex spinal cord lesion.
• Accurate volume measurement of PTS is crucial for assessing neurological deficits and treatment response.
• Standard MRI techniques can be challenging for precise PTS volume quantification.

Purpose of the Study:

• To determine the volume of posttraumatic syringomyelia (PTS) using standard MRI data acquisitions.
• To compare measured PTS volumes with patients' neurological deficits.
• To evaluate the accuracy of different MRI sequences for PTS volume measurement.

Main Methods:

• Phantom studies were conducted using T1-weighted (T1W), 3D gradient-echo (GE), and T2-weighted (T2W) spin-echo (SE) and turbo spin-echo (TSE) MRI sequences.
• Twelve fluid-filled phantoms simulating PTS were measured.
• A clinical study involved 32 patients with PTS examined using the same MRI protocol.

Main Results:

• Phantom studies showed measurement errors up to 35%, with challenges in small/irregular shapes due to partial-volume averaging.
• T2W images in the axial plane demonstrated the highest accuracy (92%) for phantom measurements.
• Clinical study revealed PTS volumes ranging from 200 to 19,800 mm³, with a mean of 4075 mm³.

Conclusions:

• Standard MRI sequences can provide objective and accurate measures of spinal cord lesions in PTS.
• Volume measurement of PTS using MRI may enhance the sensitivity for detecting disease progression or regression.
• T2-weighted axial MRI sequences show promise for precise PTS volume quantification.