Monitoring the evolution of intramedullary lesions in cervical spinal cord injury. Qualitative and quantitative analysis with sequential MR imaging

Abstract

The evolution of intramedullary lesions following an acute spinal cord injury was monitored with sequential magnetic resonance (MR) imaging. Seven patients who had sustained cervical spinal cord injuries were followed up from the acute to the chronic phase of the cord injury. MR images were evaluated not only qualitatively but also quantitatively. All intramedullary lesions were quantita tively analysed by T2 values. In the qualitative analysis, the regions with hyperintensity on T2-weighted images and isointensity on T1-weighted images were consistent with the region of simple oedema or gliosis. The former gradually disappeared after the acute phase, whereas the latter remained until the chronic phase. The regions with hyperintensity on T2-weighted images and hypointensity on Tl-weighted images may represent cysts filled with necrotic tissue or clear fluid, or necrosis. The evolution of these lesions was also able to be monitored quantitatively by T2 values.

Clinical and magnetic resonance imaging correlation in acute spinal cord injury

“…Another recent study demonstrates that MRI ®ndings of cord hematoma or contusion involving more than one spinal segment were associated with severe neurological damage. 15 Sequential MRI is recommended in the acute and subacute SCI phases to determine the prognosis ± as patterns can change over the time 9,18,19 ± and to monitor pharmacological investigation with imaging in subsequent examinations.…”

Neurologic Recovery According to Early Magnetic Resonance Imaging Findings in Traumatic Cervical Spinal Cord Injuries

“…This is because the immediate examination may be affected by associated injuries, alertness, medications, and evolving deficits 13,14. Magnetic resonance imaging (MRI) is currently the technique that best visualizes the spinal cord and adjacent soft tissues 15-21. MRI has been used as an imaging modality for the diagnosis of spinal cord injury and is known to be helpful in determining the prognosis of neurologic recovery 22-31…”