Related Experiment Videos
MR imaging of spinal cord and vertebral body infarction
1Department of Radiology, University of Iowa College of Medicine, Iowa City 52242.
Purpose:
To study the usefulness of MR in the evaluation of spinal cord infarctions and associated findings.
Materials And Methods:
MR examinations of 12 patients (10 men and two women) were reviewed retrospectively. Onset of symptoms of spinal cord ischemia was abrupt in all patients; MR was performed 8 hr to 4 months after onset. Contrast-enhanced MR was performed in four of the patients.
Results:
Abnormal MR findings of the spinal cord included abnormal cord signal (11 of 12), best demonstrated on T2-weighted images, and morphologic changes (cord enlargement during the acute phase in nine patients and cord atrophy during the chronic phase in two), best demonstrated on T1-weighted images. Vascular abnormalities (aortic) were detected by MR in four of the 12 patients. Three of these four patients also had abnormal bone marrow signal, predominantly in the anterior half (one) or in multiple areas near the endplate and/or deep medullary portion of the vertebral body involving several vertebrae (two). T1-weighted images were not sensitive in detecting signal changes in either the bone marrow (two of three) or spinal cord (nine of 12). Enhanced MR imaging was performed in four patients (two in the acute phase and two in the chronic phase) and showed diffuse enhancement of the spinal cord proximal to a relatively unenhancing distal conus in one of the two patients imaged during the acute phase. No abnormal enhancement was noted in the other three patients.
Conclusion:
MR is a useful means of detecting spinal cord infarction and associated vascular and bony changes. The patterns of bone marrow abnormalities reflect the underlying pathophysiology of the blood supply to the spinal cord and bone. The associated vascular and bone marrow abnormalities serve as additional information for the diagnosis of spinal cord infarction.
Insights
Magnetic resonance imaging (MRI) effectively detects spinal cord infarction and related vascular and bone abnormalities. This study highlights MRI
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Spinal cord infarction is a rare but serious condition.
- Early and accurate diagnosis is crucial for patient outcomes.
- Magnetic resonance imaging (MRI) is a key diagnostic tool.
Observation:
- This retrospective study reviewed 12 patients with suspected spinal cord ischemia.
- MRI was performed between 8 hours and 4 months post-symptom onset.
- Contrast-enhanced MRI was utilized in a subset of patients.
Findings:
- Abnormal spinal cord signal on T2-weighted images was observed in 11 of 12 patients.
- Morphologic changes included cord enlargement (acute) and atrophy (chronic).
- Associated vascular (aortic) and bone marrow abnormalities were detected in some patients, offering diagnostic clues.
Implications:
- MRI is a valuable tool for diagnosing spinal cord infarction.
- Identifying associated vascular and bone marrow changes provides further diagnostic support.
- Understanding these patterns aids in elucidating the pathophysiology of spinal cord ischemia.