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MR imaging in radiation myelopathy.
1Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
AJNR. American Journal of Neuroradiology
|July 1, 1992
Summary
Radiation myelopathy after nasopharyngeal carcinoma radiotherapy can be detected using MR imaging. Findings like cervical cord atrophy or abnormal signal intensity correlate with the time elapsed since symptom onset.
Area of Science:
- Radiology
- Neurology
- Oncology
Background:
- Nasopharyngeal carcinoma (NPC) treatment often involves radiotherapy.
- Radiation myelopathy is a potential complication of spinal cord irradiation.
- Early detection and characterization of radiation myelopathy are crucial for patient management.
Purpose of the Study:
- To evaluate the MR imaging findings of the cervical cord in patients with radiation myelopathy following radiotherapy for NPC.
- To correlate MR imaging characteristics (signal, size, enhancement) with the timing of symptom onset.
Main Methods:
- Retrospective analysis of MR imaging in 10 patients (3 men, 7 women; age 32-77) diagnosed with radiation myelopathy.
- MR imaging was performed between 1 and 53 months post-symptom onset.
- Assessment of cervical cord signal intensity, size, and contrast enhancement (Gd-DTPA).
Main Results:
- Two patients showed cervical cord atrophy without abnormal signal.
- Eight patients exhibited long-segment cervical cord abnormalities, including low T1 and high T2/T2* signal intensity.
- Cord swelling was observed in some cases, and focal enhancement at C1-C2 was noted in four patients.
Conclusions:
- MR imaging findings of radiation myelopathy are time-dependent.
- Atrophy without abnormal signal suggests a chronic stage (>3 years post-symptom onset).
- Abnormal signal intensity, swelling, and enhancement indicate an earlier stage (<8 months post-symptom onset).