Diffusion tensor imaging of the cervical spinal cord of patients with Neuromyelitis Optica

Double Inversion Recovery Sequence of the Cervical Spinal Cord in Multiple Sclerosis and Related Inflammatory Diseases

“…Moreover, novel MR imaging-based techniques, including diffusion tensor, magnetization transfer, and "tissue-specific" imaging, may provide estimates of the degree of tissue damage in lesions; reveal abnormalities in healthy-appearing tissue, as shown in neuromyelitis optica; and help differentiate lesions with distinct pathologic substrates (demyelination, inflammation, edema, gliosis, remyelination) but similar intrinsic signal in T2WI sequences. 9,10,24,25 Such techniques may provide valuable information beyond mere lesion visualization, and this may well be incorporated into future diagnostic guidelines.…”

“…8 In inflammatory spine diseases with a diffuse pattern, such as neuromyelitis optica, diffusion tensor imaging has recently been used to measure fractional anisotropy with great success. 9,10 The double inversion recovery (DIR) sequence was first described by Redpath and Smith in 1994. 11,12 In this sequence, the signals from both the CSF and normal white matter are suppressed simultaneously, while inflammatory lesions remain unsuppressed and appear hyperintense.…”

Test-Retest and Interreader Reproducibility of Semiautomated Atlas-Based Analysis of Diffusion Tensor Imaging Data in Acute Cervical Spine Trauma in Adult Patients

“…Establishing the reproducibility of DTI of the spine in a clinical environment has the potential to further its use in disease states in which it has shown promise. DTI can detect spinal cord abnormalities in multiple sclerosis, 7 neuromyelitis optica, 10 HIV myelopathy, 9 and spondylotic myelopathy 8 when conventional MR imaging appears normal and could potentially better guide treatment. In addition, DTI provides quantitative microstructural data that may show improved association with clinical presentation compared with conventional imaging, and its inclusion may be able to better predict outcomes.…”

“…4 Early DTI use shows promise in detecting spinal cord abnormalities associated with spinal cord injury, 5,6 demyelinating diseases, 7 spondylotic myelopathy, 8 HIV myelopathy, 9 and various inflammatory and vascular myelopathies. 10 In acute spinal cord trauma, DTI has shown value in assessing microstructural injury, differentiating between hemorrhagic and nonhemorrhagic contusions, and strong correlation with clinical injury scores. 5 Similar to brain DTI, tract-based white matter analysis of the spinal cord may offer additional insight into white matter characteristics in both healthy and diseased states.…”

Neuromyelitis optica spectrum disorders: beyond longitudinally extensive transverse myelitis

“…5,13,15 Two patients had spinal cord scans without evident hyperintense lesions. One of them underwent MRI 8 years after the clinical myelitis attack and was probably considered normal because cord atrophy was not evaluated due to the long-lasting lesion.…”