Prognosis of cervical spinal cord injury in correlation with magnetic resonance imaging

Magnetic resonance (MR) images of 18 patients with a cervical spinal cord injury were analysed for prognostic signs of paralysis. Serial MR images were obtained within 48 hours (acute stage), then 2 weeks (subacute stage) and an average of 12 months (range 6-24 months) after injury. The patterns of signal intensity in the acute stage were divided into two types, slightly-low/low (SL/L) type and slightly-low/high (SL/H) type on T1-weighted images (T1WI) and T2-weighted images (T2WI). The patterns in the subacute stage were divided into two types, high/high (H/H) type and normal/high (N/H) type on T1WI and T2WI. Six patients showed SL/L type in the acute stage and H/H type in the subacute stage. Five of the patients had a paralysis of grade A and one of grade B at admission which remained unchanged after treatment. One patient showed SL/H type in the acute stage and H/H type in the subacute stage. The patient had a paralysis of grade A that improved to no more than grade B. The remaining 11 patients showed SL/H type in the acute stage and N/H type in the subacute stage. Their paralysis was from grade B to D at admission and grade D or E at the follow up. The signal intensity of SL/L type in the acute stage and H/H type in the subacute stage are bad prognostic signs.