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M.R.I. spectrum of intrinsic spinal cord lesions
1Department of Diagnostic Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
Abstract:
We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%). MRI is more sensitive than either myelography or CT. MRI identified a previously non-visualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and haemorrhage which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate.
Insights
Magnetic resonance imaging (MRI) is a highly sensitive tool for detecting spinal cord lesions, often revealing previously unseen abnormalities and aiding diagnosis. Integrating MRI findings with clinical presentation and other imaging improves diagnostic accuracy for various spinal cord pathologies.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Spinal cord lesions require accurate diagnostic methods for effective management.
- Conventional imaging modalities like myelography and CT have limitations in visualizing intrinsic spinal cord pathology.
Purpose of the Study:
- To evaluate the diagnostic utility of magnetic resonance imaging (MRI) for intrinsic spinal cord lesions.
- To compare MRI sensitivity against other imaging techniques.
- To assess MRI's role in identifying associated pathological features.
Main Methods:
- Retrospective analysis of 42 patients with intrinsic spinal cord lesions undergoing MRI.
- Comparison of MRI findings with histological confirmation in 15 patients (36%).
- Evaluation of MRI's ability to detect previously non-visualized lesions and associated features (cysts, hemorrhage).
Main Results:
- MRI demonstrated higher sensitivity than myelography or CT for spinal cord lesions.
- MRI identified new lesions in 17 of 30 cases and crucial associated features in 13 cases.
- In multiple sclerosis cases, MRI served as the sole neuroradiological examination, showing diverse appearances.
Conclusions:
- MRI is a superior imaging modality for detecting intrinsic spinal cord lesions.
- Associated MRI findings, combined with clinical presentation and other imaging, are crucial for accurate diagnosis and differential diagnosis.
- MRI plays a vital role in the diagnosis and management of diverse spinal cord pathologies.