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Updated: May 14, 2026
Diffusion Imaging in the Rat Cervical Spinal Cord
Published on: April 7, 2015
Diffusion tensor imaging in pediatric transverse myelitis: a case study
Nadia Barakat1, M J Mulcahey, Pallav Shah
1Shriners Hospital for Children, Philadelphia, PA 19140, USA. nbarakat@shrinenet.org
Abstract:
Transverse myelitis is diagnosed based on the presence of spinal cord inflammation and the absence of infection to the central nervous system. In support of these criteria, patients undergo lumbar puncture to determine Cerebrospinal Fluid (CSF) pleocytosis and un-enhanced or Gadolinium-enhanced spinal Magnetic Resonance Imaging (MRI). We present the case of an 11~year-old previously healthy male who underwent a series of lab tests and MRI scans before a definite diagnosis of transverse myelitis four years prior to this study. The patient still shows deficits at the C4 cord level according to International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination, however, his MRI results are negative, and his Diffusion Tensor Imaging (DTI) results are close to values reported in healthy subjects.
Insights
Transverse myelitis diagnosis can be challenging. This case highlights a patient with persistent neurological deficits but normal MRI and near-normal DTI, suggesting limitations in current imaging for diagnosing spinal cord inflammation.
Area of Science:
- Neurology
- Neuroimaging
- Spinal Cord Medicine
Background:
- Transverse myelitis diagnosis relies on spinal cord inflammation evidence and excluding central nervous system infection.
- Standard diagnostic tools include lumbar puncture for cerebrospinal fluid (CSF) analysis and spinal Magnetic Resonance Imaging (MRI).
Observation:
- An 11-year-old male presented with persistent neurological deficits at the C4 cord level, four years post-initial diagnosis.
- Despite ongoing deficits, the patient's MRI scans were negative.
- Diffusion Tensor Imaging (DTI) results were comparable to those of healthy individuals.
Findings:
- This case presents a diagnostic challenge where clinical presentation of transverse myelitis persists despite negative MRI findings.
- Near-normal DTI results in a patient with established spinal cord injury symptoms warrant further investigation.
Implications:
- Current neuroimaging techniques, including advanced DTI, may not fully capture the extent of spinal cord injury in all transverse myelitis cases.
- Further research is needed to refine diagnostic criteria and identify novel biomarkers for transverse myelitis.
- This case underscores the importance of integrating clinical findings with imaging results for accurate diagnosis and management of spinal cord disorders.
