scholarly journals Increased signal intensity of spinal cord on T2W magnetic resonance imaging for cervical spondylotic myelopathy patients

Medicine ◽  
2020 ◽  
Vol 99 (49) ◽  
pp. e23098
Author(s):  
Li-qiang Yin ◽  
Jian Zhang ◽  
Yong-gui Wu ◽  
Jin-hui Li ◽  
Qing Yang
Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 217-227 ◽  
Author(s):  
Thomas F. Mehalic ◽  
Roger T. Pezzuti ◽  
Brett I. Applebaum

Abstract Nineteen patients were examined for cervical spondylotic myelopathy with magnetic resonance imaging. Pre- and postoperative magnetic resonance scans were obtained in most cases. Surgical confirmation of the pathological condition was obtained for all 19 patients. On the T2-weighted scans, there was increased signal intensity within the spinal cord at the point of maximal compression. The exact cause of the increased signal intensity on the T2-weighted images is not known, but is suspected to represent edema, inflammation, vascular ischemia, myelomalacia, or gliosis. The increased signal intensity diminished postoperatively in the patients who improved clinically, and remained the same or increased in those whose conditions remained unchanged or worsened after decompression. The authors suggest that these T2-weighted images carry prognostic significance.


2020 ◽  
Vol 7 (10) ◽  
pp. 3219
Author(s):  
Sushil Bhogawar ◽  
Prasanth Asher ◽  
Sunilkumar Balakrishnan Sreemathyamma ◽  
Anilkumar Peethambaran

Background: Cervical spondylotic myelopathy (CSM) is a commonly seen spinal cord disease. There are no well-defined indications and optimal timing for surgical intervention. Therefore, defining predictors for outcome after surgical intervention will have great advantage in taking decisions for interventions.Methods: A consecutive series of all patients having signs and symptoms of cervical spondylotic myelopathy admitted to Department of Neurosurgery, Medical College, Thiruvananthapuram who underwent decompressive surgery with or without stabilization in one year were studied. Pre-operative magnetic resonance imaging (MRI) findings were correlated with post-operative surgical outcomes (Nurick grade) after 3 months of follow up. The pattern of spinal cord signal intensity was classified as: group A (MRI N/N) - no SI T1WI or T2WI, group B (MRI N/Hi) - no SI T1WI and high SI on T2WI and, group C (MRI Lo/Hi) - low SI T1WI and high SI on T2WI. CSM clinical outcomes were evaluated using Nurick grading system, which was used pre- and post-operatively (pre op and post op).Results: Post operatively improvement was seen in 75% of group A and 61.35 % of group B patients, but among group C only 25% patient improved according to Nurick grading pre op and post op.Conclusions: Patients with high intramedullary signal intensity on T2WI may experience a good surgical outcome. A less favorable surgical outcome is predicted by the presence of low intramedullary signal on T1WI.


Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 340-347 ◽  
Author(s):  
John L. Fox ◽  
Louis Wener ◽  
Dale C. Drennan ◽  
Herbert J. Manz ◽  
Daniel J. Won ◽  
...  

Abstract A case of central cervical spinal cord injury, confirmed by magnetic resonance imaging (MRI) and treated by myelotomy, is presented. After recovering well from his central cord syndrome and walking with assistance, the patient developed a rapidly progressive myelopathy beginning 2 months after injury. His main injury localized clinically to the C8, T1 level; but central cord abnormalities were identified 3 months after injury at the C6 level by MRI: a high signal intensity on the proton density sequence and a low-signal intensity on the T1-weighted sequence. At operation 4½; months after his injury and 1 month after complete paraplegia, a myelotomy at C6 failed to reveal any cavity (syrinx) but instead disclosed only intense gliosis inside a slightly atrophic spinal cord. Rapid clinical improvement ensued. Secondary syringomyelia may be an endstage condition after spinal cord insults that trigger a progressive, pathophysiological reaction leading to central cord necrosis. In selected cases, myelotomy may interrupt this MRI-identified, nosogenic process before cavitation has occurred. (Neurosurgery 22:340-347, 1988)


2020 ◽  
Author(s):  
Zhengran Yu ◽  
Kaiyuan Lin ◽  
Jiacheng Chen ◽  
Kuan-Hung Chen ◽  
Yuguang Chen ◽  
...  

Abstract Background: Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.Methods: We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the Spinal cord/Canal Area Ratio were calculated. The compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio) and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.Results: We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p<0.05) and Ax-CCM types (ANOVA, p<0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p<0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p<0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p<0.05).Conclusions: We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.Trial registration: The trial "动态诱发电位对脊髓型颈椎病诊断和预后评估(Dynamic Somatosensory Evoked Potentials for the diagnostic and prognostic evaluation for Cervical Spondylotic Myelopathy)" was retrospectively registered on April 30th, 2020 and the registration number is "伦审[2020]151号".


2014 ◽  
Vol 14 (8) ◽  
pp. 1601-1610 ◽  
Author(s):  
Kenzo Uchida ◽  
Hideaki Nakajima ◽  
Naoto Takeura ◽  
Takafumi Yayama ◽  
Alexander Rodriguez Guerrero ◽  
...  

2013 ◽  
Vol 19 (1) ◽  
pp. 51-66
Author(s):  
Jureerat Thammaroj ◽  
Amnat Kitkhandee ◽  
Parinyaporn Tumkot ◽  
Pichayen Duangtongpol ◽  
Sakda Waraosawapati

Objective: The purpose of this study was to determine characteristic imaging findings of intramedullary spinal cord tumor in magnetic resonance imaging (MRI). Material and Methods: We retrospectively analyzed MRI in 15 patients with histologicaly proven intramedullary spinal cord tumors. The demographic data, MRI findings with histological findings were recorded in terms of age, location, length, morphology, signal intensity, the presence or absence of cyst and hemorrhage, enhancement pattern, other associated findings, necrosis, vascular proliferation and WHO grading. Results: Among the 15 patients, spinal cord ependymomas were eccentric 75%, well-define border 62.5% and cervicothoracic spine located 37.5%. Spinal cord astrocytomas were eccentrically located and ill-define border 85.7%, cervicothoracic and thoracic spine located 28.5%. A cystic component was seen in 87.5% of spinal cord ependymoma and 71.5% of astrocytomas. Intratumoral hemorrhage occurred in 75% of spinal cord ependymomas, and 57.1% of astrocytomas. In 12.5% of spinal cord ependymomas, a curvilinear low T2 signal, suggesting marginal hemorrhage, was seen at the upper and/or lower margins of the tumors. Twenty-five percent of spinal cord ependymoma and 57.2% of astrocytomas showed heterogeneous enhancement, while in 12.5% of spinal cord ependymomas, enhancement was homogeneous. Conclusion: Although no statistically significant characteristic MRI feature to distinguish between ependymoma and astrocytoma is detected. By percentage we found that border, length and signal intensity of tumors may help diagnosis. With pathological correlation, all of spinal cord ependymomas are mark hypervascular tumor, but astrocytomas never showed.


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