Spinal cord imaging using real-time high-resolution ultrasound

The myelographic evaluation of patients presenting with persistent or recurrent symptoms following surgery for an intrinsic spinal cord mass is difficult. Possible symptom-causing processes include tumor recurrence, intramedullary cyst formation, postirradiation effects, arachnoiditis, and spinal cord atrophy. Since tumor recurrence and syrinx formation may require further surgery, while the other entities generally do not, the distinction between these processes is clinically important. The authors have successfully employed commercially available high-resolution real-time ultrasound imaging systems to investigate a group of patients with these persistent or recurrent symptoms after surgery. The bony laminectomy defect provides an acoustic window for viewing intraspinal contents. Ultrasound can accurately differentiate between cystic and solid lesions and can clearly demonstrate whether a spinal cord is enlarged or atrophic.