Acute spinal cord injury: MR imaging at 1.5 T.

Abstract

Thirty-seven magnetic resonance (MR) imaging studies were performed with a 1.5-T magnet and surface coils in 27 patients with suspected spinal cord injuries. Imaging was performed 1 day to 6 weeks after injury. Cord abnormalities were seen with MR in 19 patients, while skeletal and/or ligamentous injuries were seen in 21 (78%). Three types of MR signal patterns were seen in association with cord injuries. Acute intraspinal hemorrhage was seen in five patients with cord injuries and demonstrated decreased signal intensity on T2-weighted images obtained within 24 hours of injury. Cord edema and contusion had high signal intensity on T2-weighted images and were observed in 12 cases with cord injury. Neurologic recovery, determined in 16 patients, was insignificant in patients with intraspinal hemorrhage; however, patients with cord edema or contusion recovered significant neurologic function. MR at 1.5 T is extremely useful in the diagnosis of acute cord injury and also demonstrates potential in predicting neurologic recovery.

Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations

“…Use of high‐field MRI leads to increase in signal‐to‐noise ratio and consequently to a change in image resolution;49 therefore, mild intramedullary hyperintensities in sagittal T2W sequences may be more frequently evident using 3 tesla magnetic fields. Presence of intramedullary T2W hyperintensities during acute and subacute stages of SCI is assumed to be a consequence of edema, hemorrhage, and necrosis 6, 50. This study intended not only to quantify hyperintense signal in sagittal T2W sequences but the complete extension of the SCI, including length of intramedullary intensity changes as well as extramedullary spinal cord compressions.…”

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

“…A low intensity area on T2-weighted images in the acute stage is thought to indicate more extensive intramedullary hemorrhage and is attributed to deoxyhemoglobin (Figure 4a). 6,7,12,13 Its presence has been reported to suggest a poor prognosis for neurological recovery. 4,14,15 In our patients, nine of the ten patients exhibiting this low signal change had grade A paralysis from onset to 1 year after injury ( Figure 5: pattern 4).…”

Clinical and magnetic resonance imaging correlation in acute spinal cord injury

“…Although we have studied the prognosis of all MRI patterns described according to Kulkarni's classification, 7 we propose a clinical and imaging classi®cation based on it and with SCI's severity: Type 0 (normal), Type I (edema), Type II (contusion), Type III (compression), Type IV (hemorrhage) and Type V (transection).…”