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MR Imaging for Assessing Injury Severity and Prognosis in Acute Traumatic Spinal Cord Injury

Jason F Talbott1, John Russell Huie2, Adam R Ferguson2

  • 1Department of Radiology and Biomedical Imaging, Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Room 1X57C, San Francisco, CA 94110, USA; Department of Neurological Surgery, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA 94122, USA.

Radiologic Clinics of North America
|February 3, 2019
PubMed

Insights

T2-weighted imaging is crucial for detecting acute spinal cord injury. Intramedullary hemorrhage on T2W scans indicates irreversible damage and predicts injury severity, but timing of imaging is key.

Area of Science:

  • Radiology
  • Neurology
  • Medical Imaging

Background:

  • T2-weighted (T2W) imaging is essential for diagnosing acute traumatic spinal cord pathology.
  • Intramedullary hemorrhage on T2W MRI is a strong predictor of irreversible injury and severity.
  • Spinal cord injury imaging is dynamic, requiring consideration of the time delay from injury.

Purpose of the Study:

  • To highlight the significance of T2-weighted imaging in acute spinal cord injury.
  • To emphasize the prognostic value of intramedullary hemorrhage on T2W scans.
  • To discuss the dynamic nature of spinal cord imaging and the importance of imaging timing.

Main Methods:

  • Review of current clinical practices in spinal cord injury imaging.
  • Analysis of the role of T2-weighted imaging in detecting acute traumatic spinal cord pathology.
  • Evaluation of intramedullary hemorrhage as a predictor of injury severity.
  • Discussion of the temporal dynamics of MR imaging findings in acute spinal cord injury.

Main Results:

  • T2-weighted imaging is the primary sequence for detecting acute traumatic spinal cord pathology.
  • Intramedullary hemorrhage on T2W imaging correlates with irreversible injury and predicts severity.
  • The appearance of injured spinal cord on MRI changes dynamically over time.
  • Diffusion imaging shows potential for assessing spinal cord integrity but requires further clinical validation.

Conclusions:

  • T2-weighted imaging remains the cornerstone for evaluating acute traumatic spinal cord injuries.
  • Intramedullary hemorrhage is a critical finding for assessing prognosis and injury severity.
  • Understanding the temporal evolution of imaging findings is vital for accurate interpretation.
  • Further research is needed to validate advanced techniques like diffusion imaging in clinical settings.
Keywords:
Central cord injuryContusionDiffusionHemorrhageMRISCIWORASpinal cordTensor

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