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Bildgebung bei demyelinisierenden und tumorösen Erkrankungen des Rückenmarks

Imaging of demyelinating and neoplastic diseases of the spinal cord

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Zusammenfassung

Die klinische Symptomatik von Myelopathien ist äußerst variabel und unspezifisch. Sowohl demyelinisierende als auch tumoröse Rückenmarkerkrankungen können Parästhesien, progrediente sensomotorische Ausfälle und eine Sphinkterdysfunktion hervorrufen. Bildgebende Untersuchungen, und hier allen voran die MRT, sind ein unerlässlicher Bestandteil zur Abklärung von Myelopathien und tragen wesentlich zur korrekten Diagnose bei. Intramedulläre Tumoren sind zwar weitaus seltener als demyelinisierende Rückenmarkerkrankungen, dennoch sollte der Radiologe mit den Bildmerkmalen der 3 häufigsten Tumorarten, dem Astrozytom, Ependymom und Hämangioblastom vertraut sein, die über 70% aller Rückenmarktumoren verursachen. Eine möglichst frühe Diagnostik und Therapie sind bei tumorösen und demyelinisierenden Rückenmarkerkrankungen essenziell, um bleibende neurologische Defizite möglichst gering zu halten.

Abstract

The clinical symptoms of myelopathy are variable and non-specific. Demyelinating as well as neoplastic spinal cord diseases can cause paresthesia, progressive sensomotoric deficits and bowel and bladder dysfunction. Imaging of the spine, especially with magnetic resonance imaging (MRI), is an essential component in the diagnostic assessment of myelopathy and makes a substantial contribution to achieving the correct diagnosis. Although intramedullary neoplasms are far less common than demyelinating spinal cord diseases, radiologists should be familiar with the three most common entities, astrocytoma, ependymoma and hemangioblastoma, which represent over 70% of all spinal cord neoplasms. An early diagnosis and therapy is essential with neoplastic and demyelinating spinal cord diseases to hold residual neurological deficits as low as possible.

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Literatur

  1. Hittmair K, Trattnig S, Herold CJ et al (1996) Comparison between conventional and fast spin-echo STIR sequences. Acta Radiol 37:943–949

    Article  CAS  PubMed  Google Scholar 

  2. Bot JC, Barkhof F, Lycklama a Nijeholt G et al (2002) Differentiation of multiple sclerosis from other inflammatory disorders and cerebrovascular disease: value of spinal MR imaging. Radiology 223:46–56

    Article  PubMed  Google Scholar 

  3. Hickman SJ, Miller DH (2000) Imaging of the spine in multiple sclerosis. Neuroimaging Clin North Am 10:689–704,viii

    CAS  Google Scholar 

  4. Tartaglino LM, Friedman DP, Flanders AE et al (1995) Multiple sclerosis in the spinal cord: MR appearance and correlation with clinical parameters. Radiology 195:725–732

    CAS  PubMed  Google Scholar 

  5. Stevenson VL, Leary SM, Losseff NA et al (1998) Spinal cord atrophy and disability in MS: a longitudinal study. Neurology 51:234–238

    CAS  PubMed  Google Scholar 

  6. Filippi M, Bozzali M, Horsfield MA et al (2000) A conventional and magnetization transfer MRI study of the cervical cord in patients with MS. Neurology 54:207–213

    CAS  PubMed  Google Scholar 

  7. Fardet L, Genereau T, Mikaeloff Y et al (2003) Devic’s neuromyelitis optica: study of nine cases. Acta Neurol Scand 108:193–200. DOI 20178 [pii]

    Article  CAS  PubMed  Google Scholar 

  8. Simon JH, Li D, Traboulsee A et al (2006) Standardized MR imaging protocol for multiple sclerosis: Consortium of MS centers consensus guidelines. AJNR Am J Neuroradiol 27:455–461. DOI 27/2/455 [pii]

    CAS  PubMed  Google Scholar 

  9. Seze J de, Lanctin C, Lebrun C et al (2005) Idiopathic acute transverse myelitis: application of the recent diagnostic criteria. Neurology 65:1950–1953. DOI 65/12/1950 [pii] 10.1212/01.wnl.0000188896.48308.26

    Article  PubMed  Google Scholar 

  10. American Academy of Neurology, Kerr D (2002) Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology 59:499–505

    Google Scholar 

  11. Krishnan C, Kaplin AI, Deshpande DM et al (2004) Transverse myelitis: pathogenesis, diagnosis and treatment. Front Biosci 9:1483–1499

    Article  CAS  PubMed  Google Scholar 

  12. Misra UK, Kalita J, Kumar S (1996) A clinical, MRI and neurophysiological study of acute transverse myelitis. J Neurol Sci 138:150–156

    Article  CAS  PubMed  Google Scholar 

  13. Choi KH, Lee KS, Chung SO et al (1996) Idiopathic transverse myelitis: MR characteristics. AJNR Am J Neuroradiol 17:1151–1160

    CAS  PubMed  Google Scholar 

  14. Bergmann M, Gullotta F, Kuchelmeister K et al (1993) AIDS-myelopathy. A neuropathological study. Pathol Res Pract 189:58–65

    CAS  PubMed  Google Scholar 

  15. Di Rocco A, Simpson DM (1998) AIDS-associated vacuolar myelopathy. AIDS Patient Care STDS 12:457–461

    Article  Google Scholar 

  16. Petito CK, Navia BA, Cho ES et al (1985) Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. N Engl J Med 312:874–879

    Article  CAS  PubMed  Google Scholar 

  17. Thurnher MM, Post MJ, Jinkins JR (2000) MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS. Neuroradiology 42:551–563

    Article  CAS  PubMed  Google Scholar 

  18. Chong J, Di Rocco A, Tagliati M et al (1999) MR findings in AIDS-associated myelopathy. AJNR Am J Neuroradiol 20:1412–1416

    CAS  PubMed  Google Scholar 

  19. Naidich MJ, Ho SU (2005) Case 87: Subacute combined degeneration. Radiology 237:101–105. DOI 237/1/101 [pii] 10.1148/radiol.2371031757

    Article  PubMed  Google Scholar 

  20. Murata S, Naritomi H, Sawada T (1994) MRI in subacute combined degeneration. Neuroradiology 36:408–409

    Article  CAS  PubMed  Google Scholar 

  21. Lu CH, Yao M, Liu HM, Chen YF (2007) MR findings of intrathecal chemotherapy-related myelopathy in two cases: mimicker of subacute combined degeneration. J Neuroimaging 17:184–187. DOI JON094 [pii] 10.1111/j.1552–6569.2007.00094.x

    Article  PubMed  Google Scholar 

  22. Koeller KK, Rosenblum RS, Morrison AL (2000) Neoplasms of the spinal cord and filum terminale: radiologic-pathologic correlation. Radiographics 20:1721–1749

    CAS  PubMed  Google Scholar 

  23. Epstein F (1987) Spinal cord astrocytomas of childhood. Prog Exp Tumor Res 30:135–153

    CAS  PubMed  Google Scholar 

  24. Baleriaux DL (1999) Spinal cord tumors. Eur Radiol 9:1252–1258. DOI 90091252.330 [pii]

    Article  CAS  PubMed  Google Scholar 

  25. Ciappetta P, Salvati M, Capoccia G et al (1991) Spinal glioblastomas: report of seven cases and review of the literature. Neurosurgery 28:302–306

    Article  CAS  PubMed  Google Scholar 

  26. Hentschel SJ, McCutcheon IE, Ginsberg L, Weinberg JS (2004) Exophytic ependymomas of the spinal cord. Acta Neurochir (Wien) 146:1047–1050. DOI 10.1007/s00701-004-0275-7

    Google Scholar 

  27. White JB, Miller GM, Layton KF, Krauss WE (2007) Nonenhancing tumors of the spinal cord. J Neurosurg Spine 7:403–407. DOI 10.3171/SPI-07/09/10/403

    Article  PubMed  Google Scholar 

  28. Lee DK, Choe WJ, Chung CK, Kim HJ (2003) Spinal cord hemangioblastoma: surgical strategy and clinical outcome. J Neurooncol 61:27–34

    Article  PubMed  Google Scholar 

  29. Chu BC, Terae S, Hida K et al (2001) MR findings in spinal hemangioblastoma: correlation with symptoms and with angiographic and surgical findings. AJNR Am J Neuroradiol 22:206–217

    CAS  PubMed  Google Scholar 

  30. Constantini S, Houten J, Miller DC et al (1996) Intramedullary spinal cord tumors in children under the age of 3 years. J Neurosurg 85:1036–1043. DOI 10.3171/jns.1996.85.6.1036

    Article  CAS  PubMed  Google Scholar 

  31. Patel U, Pinto RS, Miller DC et al (1998) MR of spinal cord ganglioglioma. AJNR Am J Neuroradiol 19:879–887

    CAS  PubMed  Google Scholar 

  32. Scholz M, Marzheuser-Brands S, Gottschalk J et al (1994) Intramedullary epidermoid cyst. A case report. Neurosurg Rev 17:89–93

    Article  CAS  PubMed  Google Scholar 

  33. Ferrara P, Costa S, Rigante D et al (2003) Intramedullary epidermoid cyst presenting with abnormal urological manifestations. Spinal Cord 41:645–648. DOI 10.1038/sj.sc.3101482 3101482 [pii]

    Article  CAS  PubMed  Google Scholar 

  34. Kukreja K, Manzano G, Ragheb J, Medina LS (2007) Differentiation between pediatric spinal arachnoid and epidermoid-dermoid cysts: is diffusion-weighted MRI useful? Pediatr Radiol 37:556–560. DOI 10.1007/s00247-007-0463-8

    Article  PubMed  Google Scholar 

  35. Farrokh D, Fransen P, Faverly D (2001) MR findings of a primary intramedullary malignant melanoma: case report and literature review. AJNR Am J Neuroradiol 22:1864–1866

    CAS  PubMed  Google Scholar 

  36. Patwardhan V, Patanakar T, Patkar D et al (2000) MR imaging findings of intramedullary lipomas. AJR Am J Roentgenol 174:1792–1793

    CAS  PubMed  Google Scholar 

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  1. Institut für CT und MRT Gänserndorf, Schubertstr. 6a, A-2230, Gänserndorf, Österreich

    C. Mueller-Mang

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Mueller-Mang, C. Bildgebung bei demyelinisierenden und tumorösen Erkrankungen des Rückenmarks. Radiologe 50, 1073–1083 (2010). https://doi.org/10.1007/s00117-010-2029-2

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