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Updated: Jan 9, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Spinal cord infarction demonstrated by diffusion-weighted magnetic resonance imaging
Mizuya Shinoyama1, Toshiyuki Takahashi, Hiroaki Shimizu
1Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
Abstract:
Spinal cord infarction is a rare entity of varying etiology although most often associated with atherosclerotic aortic disease. Definitive diagnosis of (idiopathic) spinal cord infarction in the acute stage and in the absence of demonstrable predisposing factors is not always possible even with MRI. Diffusion-weighted MRI (dwMRI) may provide valuable information in the evaluation of spinal cord ischemia. A 45-year-old woman presented with idiopathic spinal cord infarction manifesting as sudden onset of paraparesis and sphincter dysfunction. Both T2-weighted and line-scan dwMRI revealed hyperintense signals in the dorsal part of the spinal conus. Apparent diffusion coefficient values were significantly low in the lesion, suggesting cytotoxic edema compatible with acute ischemia. The clinical course and other radiographic findings were also compatible with idiopathic spinal cord infarction. Diffusion-weighted MRI is an important diagnostic tool for examining patients with suspected spinal cord ischemia.
Insights
Spinal cord infarction, though rare, can be diagnosed acutely using diffusion-weighted MRI (dwMRI). This advanced imaging technique helps identify cytotoxic edema, confirming acute spinal cord ischemia.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Spinal cord infarction is a rare neurological event, often linked to aortic disease.
- Diagnosing acute spinal cord infarction, especially idiopathic cases, can be challenging even with conventional MRI.
- Diffusion-weighted MRI (dwMRI) offers potential for improved early detection.
Observation:
- A 45-year-old woman presented with acute paraparesis and sphincter dysfunction, suggestive of spinal cord infarction.
- T2-weighted and line-scan dwMRI showed hyperintense signals in the dorsal spinal conus.
- Low apparent diffusion coefficient values indicated cytotoxic edema, consistent with acute ischemia.
Findings:
- The patient's presentation and imaging findings were consistent with idiopathic spinal cord infarction.
- dwMRI revealed characteristic changes of acute ischemia in the spinal cord.
- The diagnostic utility of dwMRI in spinal cord ischemia was demonstrated.
Implications:
- Diffusion-weighted MRI is a valuable tool for the acute diagnosis of spinal cord infarction.
- Early and accurate diagnosis can potentially lead to timely intervention and management.
- This case highlights the importance of advanced MRI techniques in diagnosing rare neurological conditions.
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