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The role of magnetic resonance imaging in acute transverse myelitis

S G Austin1, C S Zee, C Waters

  • 1Department of Neurology, University of Southern California, Los Angeles County Medical Center.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|November 1, 1992
PubMed

Insights

Magnetic resonance imaging (MRI) for acute transverse myelitis (ATM) is most effective when performed over 5 days after symptom onset. While MRI findings in ATM may not predict prognosis, they are crucial for excluding other spinal cord conditions.

Area of Science:

  • Neurology
  • Radiology
  • Spinal Cord Imaging

Background:

  • Acute transverse myelitis (ATM) is a debilitating neurological condition affecting the spinal cord.
  • Accurate diagnosis and prognostic indicators for ATM are essential for patient management.

Purpose of the Study:

  • To evaluate the utility of magnetic resonance imaging (MRI) in adult patients with acute transverse myelitis (ATM).
  • To determine the correlation between MRI findings and ATM's cause, severity, and prognosis.
  • To identify optimal timing for MRI in ATM diagnosis.

Main Methods:

  • Retrospective analysis of MRI scans from 18 adult patients diagnosed with ATM.
  • Correlation of MRI findings (T1 and T2 weighted images) with clinical data including etiology, neurological deficit, and prognosis.
  • Assessment of scan timing relative to disease onset.

Main Results:

  • Only 7 out of 18 patients showed MRI abnormalities, characterized by increased signal intensity on T2-weighted images only; T1-weighted images were consistently normal.
  • No significant correlation was found between MRI abnormalities and the cause, neurological deficit extent, or prognosis of ATM.
  • MRI scans performed more than 5 days after symptom onset were more likely to reveal abnormalities.

Conclusions:

  • While MRI findings in ATM may have limited prognostic value, the technique is vital for differentiating ATM from other non-compressive spinal cord lesions like tumors or vascular malformations.
  • Early MRI may not detect abnormalities in all ATM cases, suggesting a potential benefit from delayed imaging.
  • MRI remains an indispensable tool in the diagnostic workup of suspected acute transverse myelitis.

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