Diffusion-weighted MRI in acute spinal cord ischaemia
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Acute spinal cord ischaemia is often undetectable with conventional MRI. Diffusion-weighted MRI (DWI) has been difficult to use in the spine because of susceptibility artefacts. We assessed the diagnostic value of echoplanar DWI for early confirmation of spinal cord ischaemia. We performed conventional MRI and DWI in two men and three women, aged 54–75 years with clinically suspected acute spinal cord ischaemia. Imaging was performed 9–46 h after the onset of symptoms, and 2–9 days later to assess the extent of ischaemic signal change. Spatial resolution of DWI within the spine using standard equipment was poor, but in all patients, early DWI revealed areas of high signal indicating decreased diffusion, confirmed by measurement of apparent diffusion coefficients. Follow-up MRI showed high signal on T2-weighted images and contrast enhancement at the expected levels. Neurological deficits corresponded with radiological findings in four patients: various syndromes, including isolated bilateral weakness or sensory change and combined deficits, were found. Echoplanar DWI may be helpful for confirmation of spinal cord ischaemia in the acute stage, but follow-up T2-weighted images have superior spatial resolution and correlation with clinical findings and lesion extent.
KeywordsSpinal cord infarcts Diffusion-weighted magnetic resonance imaging
This study was funded in part by a grant from the Swiss National Science Foundation (SNF 3100-66348.01).
- 3.Lövblad KO, Laubach HJ, Baird AE, et al (1998) Clinical experience with diffusion-weighted MR in patients with acute stroke. AJNR 19: 1061–1066Google Scholar
- 6.Holder CA, Muthupillai R, Mukundan S Jr, Eastwood JD, Hudgins PA (2000) Diffusion-weighted MR imaging of the normal human spinal cord in vivo. AJNR 21: 1799–1806Google Scholar
- 11.Pattany PM, Puckett WR, Klose KJ, et al (1997) High-resolution diffusion-weighted MR of fresh and fixed cat spinal cords: evaluation of diffusion coefficients and anisotropy. AJNR 18: 1049–1056Google Scholar
- 12.Bammer R, Fazekas F, Augustin M, et al (2000) Diffusion-weighted MR imaging of the spinal cord. AJNR 21: 587–591Google Scholar
- 15.Maier SE, Gutbjartsson H, Patz S, et al (1998) Line scan diffusion imaging: characterization in healthy subjects and stroke patients. Am J Roentgenol 171: 85–93Google Scholar
- 16.Lövblad KO, Jakob PM, Chen Q, et al (1998) Turbo spin-echo diffusion-weighted MR of ischemic stroke. AJNR 19: 201–208Google Scholar