Spinal Cord Infarction Versus Idiopathic Transverse Myelitis: Clinical, Radiological, and Functional Insights From a...

Area of Science:

• Neurology
• Radiology
• Myelopathy Research

Background:

• Spinal cord infarction (SCI) is a rare but severe myelopathy with poor prognosis.
• SCI is frequently misdiagnosed as idiopathic transverse myelitis (ITM).
• Accurate differentiation is crucial for appropriate patient management.

Purpose of the Study:

• To delineate clinical features of SCI.
• To identify radiological biomarkers for SCI diagnosis.
• To distinguish SCI from ITM based on clinical and imaging findings.

Main Methods:

• Retrospective observational cohort study (January 2019 - October 2024).
• Inclusion of patients diagnosed with SCI and ITM.
• Analysis of clinical data, radiological findings (including DWI, ADC, T2-weighted MRI), and functional outcomes.
• Univariate analysis for group differentiation.

Main Results:

• 22 SCI patients identified; 12 confirmed via DWI/ADC.
• SCI onset-to-nadir time significantly shorter than ITM (mostly within 6 hours).
• SCI shows linear sagittal MRI lesions; ITM presents as patchy/fusiform lesions.
• A novel "eccentric sign" on T2-weighted MRI identified for SCI.
• SCI patients generally experience poorer prognosis and higher dependence.

Conclusions:

• Clinical features and specific radiological signs can diagnose SCI.
• MRI biomarkers, including lesion morphology and the "eccentric sign", differentiate SCI from ITM.
• Early and accurate diagnosis of SCI is achievable, improving patient outcomes.