Increased MR signal intensity due to cervical myelopathy

Abstract

The cases of 29 patients with cervical myelopathy, who had been treated by anterior spine fusion, were reviewed. The relationship between pre- and postoperative magnetic resonance (MR) images was investigated with special reference to increased signal intensity in the spinal cord on the T2-weighted images and the relevance of this finding to clinical conditions. Preoperatively, there were areas of increased signal intensity in 12 patients whereas there were no areas of increased signal intensity in the other 17. The lesions were not clearly demonstrated on T1-weighted images. The pre- and postoperative clinical condition of the patients whose preoperative MR images showed areas of increased signal intensity in the spinal cord on T2-weighted images was worse than that of the patients who did not have areas of increased signal intensity. Of the 12 patients with regions of increased signal intensity preoperatively, five showed decreased signal intensity postoperatively compared to the preoperative levels and seven had no change. The postoperative recovery of the five patients who showed decreased signal intensity postoperatively was better than that of the seven patients who exhibited no change. The areas of increased MR signal in the spinal cord might be due to edema, cord gliosis, demyelination, or microcavities.

Postmortem study of the spinal cord showing snake-eyes appearance due to damage by ossification of the posterior longitudinal ligament and kyphotic deformity

“…[1][2][3][4][5][6][7][8] SEA is a unique radiological finding that can be observed in cases with compression myelopathy, kyphotic deformity or spinal cord injury. The term 'snake-eyes appearance' is derived from the resemblance of the bilateral small IMHSI in the compressed cord to the face of a snake.…”

“…This term may be the same as 'fried-egg appearance' demonstrated by computed-tomographic myelography by Iwasaki et al 9 Some authors suggested that SEA is an irreversible change in the spinal cord, like cystic necrosis. 3,7,8,10 Others suggested that it is a reversible change, similar to edema. 3,6,8 This confusion arises from a lack of precise pathological correlation of the compressed spinal cord with SEA.…”

“…3,7,8,10 Others suggested that it is a reversible change, similar to edema. 3,6,8 This confusion arises from a lack of precise pathological correlation of the compressed spinal cord with SEA.…”

Cervical curvature, spinal cord MRIT2 signal, and occupying ratio impact surgical approach selection in patients with ossification of the posterior longitudinal ligament

“…Spinal MRIT2 signal change can signal pathological changes in the spinal gray matter [22]. Matsuda et al [22] found that patients with preoperative spinal MRIT2 signal change exhibited an increased tendency to be affected by heavy spinal cord injury, often resulting in poor postoperative recovery.…”

“…Matsuda et al [22] found that patients with preoperative spinal MRIT2 signal change exhibited an increased tendency to be affected by heavy spinal cord injury, often resulting in poor postoperative recovery. Based on the current findings, OPLL patients with higher levels of spinal stenosis are much more likely to have elevated spinal MRIT2 signals.…”