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Compressive myelopathy: magnetic resonance imaging findings simulating idiopathic acute transverse myelopathy

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Abstract

Objective

To provide magnetic resonance imaging (MRI) findings of compressive myelopathy simulating idiopathic acute transverse myelopathy (ATM).

Materials and methods

From 19,416 patients who had spinal MRI from 1 September 2004 to 10 July 2011, the patients who met inclusion criteria were enrolled as follows: (1) definable cord compression, (2) long-segmental intramedullary T2-high signal intensity (HSI) extending more than 2 vertebral segments, and (3) no history of trauma, malignancy, or demyelinating disease. The characteristics of T2-HSI and contrast enhancement pattern were analyzed. The patients’ clinical information was collected in the process.

Results

Thirteen patients (10 men, 3 women; mean age, 52.8 years; age range, 43–77 years) were included in this study. Twelve patients had cervical cord compression and one had thoracic compression. Common findings of T2-HSI included fusiform shape (100 %) with cord swelling (92.3 %), cord compression in midline location (76.9 %), diffuse distribution occupying more than two-thirds of the cross-sectional dimension of the cord in axial image (84.6 %), and focal and peripheral enhancement (63.6 %). Intravenous corticosteroid was administered to four patients, including two patients following decompressive surgery, and interval decrease in T2-HSI was seen in three patients, but with residual lesions at cord compression level.

Conclusions

Spinal cord compression can induce long-segmental cord signal change, such as idiopathic ATM.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Yun Jung Bae, Joon Woo Lee, Guen Young Lee & Heung Sik Kang

  2. Department of Neurology, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Kyung Seok Park

  3. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Jin S. Yeom

  4. Department of Neurosurgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Ki-Jeong Kim

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  1. Yun Jung Bae
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  2. Joon Woo Lee
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Correspondence to Joon Woo Lee.

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Bae, Y.J., Lee, J.W., Park, K.S. et al. Compressive myelopathy: magnetic resonance imaging findings simulating idiopathic acute transverse myelopathy. Skeletal Radiol 42, 793–802 (2013). https://doi.org/10.1007/s00256-012-1556-5

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  • DOI: https://doi.org/10.1007/s00256-012-1556-5

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