Technological advances in diagnostic imaging make the diagnosis of spinal trauma more accurate both in the acute and in the chronic settings. Improvements in medical care and in diagnostic imaging lead to an increasing prevalence of patients' surviving injuries. The management of these patients depends on early and appropriate radiological evaluation in the acute phase. The aim of this work was to review advanced imaging modalities employed to study thoracic spine and spinal cord in injured patients.

Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It has recently been described as a rare subtype of multiple sclerosis (MS) characterised by the appearance of solitary or multiple space-occupying lesions associated with imaging characteristics mimicking neoplasm. Atypical features include plaque size >2 cm with mass effect, oedema, and/or ring enhancement on magnetic resonance (MR) images.This study is a retrospective review designed to evaluate the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to our MS centre in Southern Italy between 2005 and 2014. We analysed the radiographic features of lesions ranging in size from 0.5 to 2 cm to establish whether smaller plaques with MR characteristics similar to tumefactive plaques present different symptoms, disease evolution and prognosis. We also aimed to ascertain if MR features suggestive of biological aggressiveness could be useful prognostic criteria for a correct diagnosis of the disease and subsequent treatment. Our data suggest that lesions 0.5-2 cm and >2 cm have similar MR features and clinical evolution.

This work is an imaging review of spine after surgery with special regard to imaging modality in intervertebral disc pathology. Advances in imaging technology can be evaluated. Depending on the clinical question is asked to the radiologist, it is possible to evaluate post-operative patients with conventional radiology (X-ray), computed tomography and magnetic resonance. Main indications for each technique are analysed. Imaging is important in the diagnosis of many forms of spine pathology and plays a fundamental role in evaluating post-surgical effects of treatments, according to the imaging method which is used, both on spine and on its surrounding tissues (intervertebral discs, spinal cord, muscles and vessels).

CCT is performed with different workloads in participating centers. It is a safe procedure and its results have a strong impact on patient management.

Although tumefactive multiple sclerosis is a well recognized variant of multiple sclerosis, prognostic uncertainty still exists about long term prognosis. The aim of this study was to estimate the occurrence and long term outcome of tumefactive demyelinating lesions (TDLs) in a cohort of multiple sclerosis patients. We reviewed brain MRI of 443 patients referred to our MS clinic. All patients meeting the McDonald criteria for multiple sclerosis and showing at least one TDL were included. Kaplan-Meier estimates of disease-free survival in patient cohort were compared with control group without TDLs using a log-rank test. Seven cases with TDLs were identified (occurrence 1.58 %). Tumefactive demyelinating lesion recurrence was 16.6 %. Cumulative proportion of patients free from clinical relapse and from new T2 lesions was lower in the control group although not reaching statistical significance (30 vs 50 %; P = 0.666 and 21.7 vs 33.3 %; P = 0.761, respectively). Disability progression analysis showed a not significant trend towards lower probability of remaining progression free for TDL patients (50 vs 61 %; P = 0.295). Occurrence of tumefactive demyelinating lesions in our cohort was higher than those reported in other studies. Overall, TDLs were not predictive of poor outcome in terms of disability progression.