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Hirayama disease: MR diagnosis

C J Chen1, C M Chen, C L Wu

  • 1Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Medical College, Taipei, Taiwan, Republic of China.

AJNR. American Journal of Neuroradiology
|March 21, 1998
PubMed
Summary

Hirayama disease, a cervical myelopathy, shows characteristic MRI findings. Flexion MRI reveals anterior dura shifting, while nonflexion MRI may show subtle cord atrophy, aiding diagnosis.

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Area of Science:

  • Neurology
  • Radiology
  • Spinal Cord Imaging

Background:

  • Hirayama disease is a rare cervical myelopathy.
  • It is associated with neck flexion movements.
  • Diagnosis can be challenging based on clinical presentation alone.

Observation:

  • Two cases of Hirayama disease were evaluated using Magnetic Resonance (MR) imaging.
  • Specific MR sequences were performed in both flexion and nonflexion positions.
  • Clinical correlation with imaging findings was emphasized.

Findings:

  • Flexion MR studies demonstrated a pathognomonic finding of anterior shifting of the posterior dura mater in the lower cervical spinal canal.
  • Nonflexion MR studies revealed subtle, asymmetric cord atrophy, particularly in the lower cervical region.

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  • These imaging features are highly suggestive of Hirayama disease.

    • Implications:

    • MR imaging, especially with flexion views, is crucial for diagnosing Hirayama disease.
    • Identifying characteristic MRI findings can lead to earlier and more accurate diagnosis.
    • Understanding these imaging patterns aids neurologists and radiologists in differentiating Hirayama disease from other myelopathies.