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Idiopathic transverse myelitis: MR characteristics
1Department of Radiology, Kangman St Mary's Hospital, Catholic University Medical College, Seocho-Ku, Seoul, Korea.
AJNR. American Journal of Neuroradiology
|June 1, 1996
Summary
Magnetic resonance imaging (MRI) can help differentiate transverse myelitis from other spinal cord lesions. Characteristic MRI findings, combined with clinical assessment, are key for accurate diagnosis and monitoring treatment response.
Area of Science:
- Neurology
- Radiology
- Spinal Cord Imaging
Background:
- Idiopathic transverse myelitis is an inflammatory condition affecting the spinal cord.
- Distinguishing it from other intramedullary lesions like tumors or multiple sclerosis is crucial for proper management.
Purpose of the Study:
- To identify specific magnetic resonance (MR) imaging characteristics that differentiate idiopathic transverse myelitis from other intramedullary lesions.
- To correlate MR findings with clinical presentation and disease progression.
Main Methods:
- Retrospective review of 32 MR studies in 17 patients with clinically diagnosed transverse myelitis.
- Analysis of T2-weighted and T1-weighted MR images for lesion location, size, pattern, and contrast enhancement.
- Evaluation of follow-up MR studies in 10 patients.
Main Results:
- Common findings include centrally located T2 hyperintensity (88%), affecting 3-4 vertebral segments (53%), with cord expansion in 47%.
- Focal, peripheral cord enhancement was observed in 53% of patients, especially those with cord expansion.
- A small central area isointense with normal cord was seen in 47% of cases.
Conclusions:
- MR imaging findings are valuable for diagnosing transverse myelitis and differentiating it from multiple sclerosis and cord tumors.
- Clinical assessment and serial MR monitoring are essential for definitive diagnosis and management.