In patients with acute traumatic cervical spinal cord injury, it is di cult to make a precise diagnosis of the main site of the injury, the severity of cord damage, and the prognosis of neurological complications Objective: To determine which images provide the most useful information and the best time to perform prognostic MRI. Design: The severity of neurological complications was assessed using the ASIA impairment scale. MRI was ®rst performed within 48 h of injury, and was subsequently performed after 2 ± 3 weeks, 3 months, 6 months, and 1 year. Setting: Inpatient SCI medicine unit. Subjects: Seventy-®ve patients with acute traumatic cervical spinal cord injury (9 women and 66 men) aged from 19 ± 89 years (mean: 54.7 years). Results: Four characteristic patterns of signal changes were observed on MRI. These patterns correlated well with the severity of spinal cord damage and the clinical outcome. Conclusion: T2-weighted images provided the most useful information, and the best times for prognostic imaging were at the time of injury and 2 ± 3 weeks later.
A prospective sequential MRI study was done to investigate the morphologic changes of the lumbar disc hernia (LDH). We also studied the relationship between the MRI changes and the type of LDH and the clinical outcome. MRI was performed every 3 months from the onset for a maximum of 24 months in 42 patients with radicular leg pain and symptoms definitely diagnosed as caused by LDH. The size of the herniated mass was determined by the ratio of the anteroposterior diameter of the spinal canal to the maximum diameter of the LDH mass on T2-weighted axial images. The clinical outcome was evaluated as excellent, good, or poor depending on leg pain and physical findings. The JOA (Japanese Orthopaedic Association) score for LDH was also used to assess the outcome. Thirty-seven (88%) of the 42 patients showed >50% reduction of the hernia on MRI 3-12 months after onset, and the morphologic changes of the herniated mass were well correlated with the clinical outcome.
Sequential magnetic resonance imaging (MRI) of 23 patients who suffered cervical spinal cord injury without bony injury was performed prospectively, The major cord injury detected by MRI was at the C3-4 disc level in 16 patients (70%), Three patterns of signal changes were observed, Enhancement of the injured cord was observed on Gd-DTPA enhanced MRI in 10 patients and the palsy of these patients was more severe than that of those without enhancement. Enhancement was recognised about 2 weeks earlier than the signal change (from isointense to low intensity) on T1-weighted images. This enhancement might represent necrosis, absorption, and reorganisation of the spinal cord, and appears to be a sign of a poor prognosis or an indication that damage is permanent. Another characteristic imaging finding was a vague high intensity signal in the dorsal column of the spinal cord extending rostrally from the main lesion, which appeared 2-3 months after injury and disappeared around 6 months. This finding represents Wallerian degeneration of the corticospinal tract in the cervical cord, Rigidity of the legs and sensory changes of the fingers became more prominent during this period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.