Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study

Abstract

Diffusion-weighted imaging (DWI) is frequently used to differentiate cerebral lesions. The aim of our study was to evaluate the diagnostic value of DWI and the measurement of the apparent diffusion coefficient (ADC) in noncompressive myelopathy explorations. Thirty-three patients presenting a spinal cord syndrome due to a noncompressive myelopathy underwent spinal cord MRI between September 2005 and November 2008. For each patient, the ADC was calculated in the pathological spinal cord. ADC values were also measured in the healthy spinal cord of ten control subjects. Statistical analysis was based on the Student's t test. Twenty-one patients presented an inflammatory myelopathy: Nine patients presented multiple sclerosis, three patients presented a parainfectious myelopathy, two patients acute disseminated encephalomyelitis, one patient neuromyelitis optica, one patient systemic lupus erythematosus, and five patients a myelopathy of unknown aetiology. Six patients presented a spinal cord infarction. ADC values were significantly lower in spinal cord infarct (mean ADC = 0.81 +/- 0.08 x 10(-3) mm(2)/s) than in inflammatory spinal cord lesions (mean ADC = 1.37 +/- 0.23 x 10(-3) mm(2)/s) and in healthy control spinal cord (mean ADC = 0.93 +/- 0.07 x 10(-3) mm(2)/s). These results are important to differentiate ischaemic from inflammatory myelopathies, especially at the acute phase when clinical presentation and extensive work-up are not able to show an aetiologic diagnosis. Although these results are similar to those described in cerebral explorations, ADC measurements remain technically limited for the moment.

Anterior Spinal Artery Thrombosis Following Trivial Trauma in A Young Girl-Case Report and Review of Literature

“…Diffusion weighted MRI should be used to distinguish acute ischemia from other causes of myelitis [10]. Antero-central cord infarction can be seen on axial sections as the typical owl eye appearance [11].…”

Diffusion-weighted MR imaging within 24 h post-injury after traumatic spinal cord injury: a qualitative meta-analysis between T2-weighted imaging and diffusion-weighted MR imaging in 18 patients

“…18 Remarkably, the study concluded that future DWI may provide important information complementary to conventional MRI, and allow for a better prognostic evaluation of recovery. 18 The study by Marcel et al 25 showed that, in some cases, the high signal on DWI in spinal cord lesions was associated with an increased signal on ADC, which means elevated diffusion. This can be explained by the T2 shine-through effect.…”

Restricted Diffusion in Spinal Cord Infarction Demonstrated by Magnetic Resonance Line Scan Diffusion Imaging

“…Criteria for SCI diagnosis included an acute deficit; spinal cord imaging corresponding to spinal artery territory as described by Masson et al; and no other diagnosis after extensive work-up, including evaluation for autoimmune and hypercoagulable disorders, viral serologies and cerebrospinal fluid analysis, gadolinium-enhanced brain MRI, and evoked potentials (unless the etiology was clear based on the clinical scenario). 2 …”

“…Diffusionweighted magnetic resonance imaging (MRI) has proven to be the most sensitive diagnostic tool in acute cerebral ischemia and has become a promising technique in the evaluation of acute spinal cord syndromes. 1,2 We report our experience with the utilization of magnetic resonance (MR) line scan diffusion imaging (LSDI) for the evaluation of SCI.…”