Cerebral and spinal cord changes observed through magnetic resonance imaging in patients with HTLV-1–associated myelopathy/tropical spastic paraparesis: a systematic review

Study Design: Systematic review and meta-analysis. Objectives: Cervical spinal cord compression (SCC) due to degenerative changes of the spine is a frequent finding on magnetic resonance imaging (MRI). While most people remain asymptomatic, a proportion develop symptoms of degenerative cervical myelopathy (DCM). DCM is an often-progressive neurological disease that can cause quadriplegia. The epidemiology of SCC and DCM is poorly understood. We sought to estimate the prevalence of degenerative cervical SCC and DCM from cross-sectional cohorts undergoing MRI. Methods: We conducted a systematic review and meta-analysis of MRI reports on human subjects older than 16 years with degenerative SCC. A predetermined search strategy was used to identify relevant literature on MEDLINE. Title and abstract screenings were followed by full text screening. Data was extracted and analyzed by fixed or random-effects models. Results: The present search returned 1506 publications. Following our exclusion criteria, 19 studies were included. Subgroup analysis of 3786 individuals estimated the prevalence of asymptomatic SCC in a healthy population as 24.2% with a significantly higher prevalence of SCC in older populations compared with younger populations and American/European populations compared with Asian populations. Subgroup analysis of 1202 individuals estimated the prevalence of DCM in a healthy population as 2.3%. Conclusions: We present the first estimates of the prevalence of asymptomatic SCC and DCM. Studies investigating the epidemiology of SCC are heterogeneous in methodology and results. These data indicate the need for more studies into the epidemiology of SCC and DCM performed with consistent methodologies.

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HIV-associated vacuolar myelopathy: A rare initial presentation of HIV

SAGE Open Medical Case Reports ◽

10.1177/2050313x20945562 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2094556

Author(s):

Aida Rezaie ◽

Rajeshwar Parmar ◽

Casey Rendon ◽

Steven C Zell

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Spastic Paraparesis ◽

Initial Presentation ◽

Resonance Imaging ◽

Spinal Cord Atrophy ◽

Vacuolar Myelopathy ◽

The Common ◽

Advanced Immunosuppression

HIV-associated vacuolar myelopathy, or AIDS-associated myelopathy, is a rare initial presentation of HIV. One of the common HIV-associated neurocognitive disorders, HIV-associated vacuolar myelopathy presents with advanced immunosuppression in patients and is frequently associated with dementia. However, most cases are subclinical with characteristic findings identified through physical examination and/or imaging modalities. HIV-associated vacuolar myelopathy is characterized by progressive spastic paraparesis, gait disturbance and lower extremity sensory abnormalities including vibratory sensation. Magnetic resonance imaging findings in the spinal cord are abnormal in some patients with HIV-associated myelopathy, characteristically showing spinal cord atrophy at the level of the thoracic spine, but they may also be normal. Unfamiliarity with this as initial presentation of HIV infection may lead to failure to diagnose and intervene appropriately. We present a case of newly diagnosed HIV with myelopathy and dementia with minimal spinal cord involvement on magnetic resonance imaging.

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Faculty Opinions recommendation of Diffusion tensor magnetic resonance imaging of Wallerian degeneration in rat spinal cord after dorsal root axotomy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1158368.618517 ◽

2009 ◽

Author(s):

David Choi ◽

Carolina Kachramanoglou

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Dorsal Root ◽

Wallerian Degeneration ◽

Diffusion Tensor ◽

Resonance Imaging ◽

Rat Spinal Cord

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Faculty Opinions recommendation of Radiologically isolated syndrome--incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717984800.793477731 ◽

2013 ◽

Author(s):

Jeremy Chataway

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Systematic Review ◽

Magnetic Resonance ◽

Imaging Findings ◽

Resonance Imaging ◽

Radiologically Isolated Syndrome

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Changes of Dorsal Root Ganglion Volume in Dogs with Clinical Signs of Degenerative Myelopathy Detected by Water-Excitation Magnetic Resonance Imaging

Animals ◽

10.3390/ani11061702 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1702

Author(s):

Eiji Naito ◽

Kohei Nakata ◽

Yukiko Nakano ◽

Yuta Nozue ◽

Shintaro Kimura ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Clinical Signs ◽

Intervertebral Disc Herniation ◽

Resonance Imaging ◽

Diagnostic Potential ◽

Water Excitation ◽

Spinal Cord Segment ◽

Degenerative Myelopathy

Canine degenerative myelopathy (DM) is a progressive and fatal neurodegenerative disease. However, a definitive diagnosis of DM can only be achieved by postmortem histopathological examination of the spinal cord. The purpose of this study was to investigate whether the volumetry of DRG using the ability of water-excitation magnetic resonance imaging (MRI) to visualize the DRG in dogs has premortem diagnostic value for DM. Eight dogs with DM, twenty-four dogs with intervertebral disc herniation (IVDH), and eight control dogs were scanned using a 3.0-tesla MRI system, and water-excitation images were obtained to visualize and measure the volume of DRG, normalized by body surface area. The normalized mean DRG volume between each spinal cord segment and mean volume of all DRG between T8 and L2 in the DM group was significantly lower than that in the control and the IVDH groups (P = 0.011, P = 0.002, respectively). There were no correlations within the normalized mean DRG volume between DM stage 1 and stage 4 (rs = 0.312, P = 0.128, respectively). In conclusion, DRG volumetry by the water-excitation MRI provides a non-invasive and quantitative assessment of neurodegeneration in DRG and may have diagnostic potential for DM.

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Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽

10.1227/01.neu.0000215891.25153.ba ◽

2006 ◽

Vol 58 (6) ◽

pp. 1081-1089 ◽

Cited By ~ 89

Author(s):

John Sinclair ◽

Steven D. Chang ◽

Iris C. Gibbs ◽

John R. Adler

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Arteriovenous Malformations ◽

Conus Medullaris ◽

Spinal Angiography ◽

Resonance Imaging ◽

Intramedullary Spinal Cord ◽

Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

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