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Value of diffusion-weighted MR imaging in acute cervical cord injury as a predictor of outcome

  • Diagnostic Neuroradiology
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Abstract

Introduction

We analyzed the findings of diffusion-weighted (DW) imaging using the single-shot fast spin-echo sequence in acute cervical cord injury and evaluated the usefulness of this method for predicting the prognosis.

Methods

Our patient group comprised 14 patients examined 2 h to 3 days after injury. First, we visually evaluated the DW imaging findings in all patients. Apparent diffusion coefficient (ADC) maps were also assessed in 13 patients. Second, we assessed follow-up magnetic resonance (MR) examinations obtained in six patients whose DW images showed hyperintensity. Third, we reviewed the functional outcome at discharge.

Results

The lesions showed hyperintensity in ten patients, and no abnormal signal was noted in the remaining four patients. The ADC maps showed restricted diffusion in all patients with hyperintensity on DW imaging except in one patient for whom the ADC map was unavailable. Repeated MR examinations obtained in six of the ten patients showed either myelomalacia or exacerbation. Seven of the ten patients (70%) required assistance and the other three were independent. Among the four patients without hyperintensity on DW imaging, three (75%) were independent and only one required assistance.

Conclusion

DW imaging in acute cervical cord injury often reveals restricted diffusion. This finding may predict an unfavorable functional prognosis.

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References

  1. Beers GJ, Raque GH, Wagner GG, Shields CB, Nichols GR 2nd, Johnson JR, Meyer JE (1998) MR imaging in acute cervical spine trauma. J Comput Assist Tomogr 12:755–761

    Article  Google Scholar 

  2. Flanders AE, Schaefer DM, Doan HT, Mishkin MM, Gonzalez CF, Northrup BE (1990) Acute cervical spine trauma: correlation of MR imaging findings with degree of neurologic deficit. Radiology 177:25–33

    PubMed  CAS  Google Scholar 

  3. Kerslake RW, Jaspan T, Worthington BS (1991) Magnetic resonance imaging of spinal trauma. Br J Radiol 64:386–402

    Article  PubMed  CAS  Google Scholar 

  4. Barzo P, Marmarou A, Fatouros P, Hayasaki K, Corwin F (1997) Contribution of vasogenic and cellular edema to traumatic brain swelling measured by diffusion-weighted imaging. J Neurosurg 87:900–907

    PubMed  CAS  Google Scholar 

  5. Liu AY, Maldjian JA, Bagley LJ, Sinson GP, Grossman RI (1999) Traumatic brain injury: diffusion-weighted MR imaging findings. AJNR Am J Neuroradiol 20:1636–1641

    PubMed  CAS  Google Scholar 

  6. Robertson RL, Maier SE, Mulkern RV, Vajapayam S, Robson CD, Barnes PD (2000) MR line-scan diffusion imaging of the spinal cord in children. Am J Neuroradiol 21:1344–1348

    PubMed  CAS  Google Scholar 

  7. Fujikawa A, Tsuchiya K, Takeuchi S, Hachiya J (2004) Diffusion-weighted MR imaging in acute spinal cord ischemia. Eur Radiol 14:2076–2078

    Article  PubMed  Google Scholar 

  8. Tsuchiya K, Katase S, Fujikawa A, Hachiya J, Kanazawa H, Yodo K (2003) Diffusion-weighted MRI of the cervical spinal cord using a single-shot fast spin-echo technique: findings in normal subjects and in myelomalacia. Neuroradiology 45:90–94

    PubMed  CAS  Google Scholar 

  9. Ford JC, Hackney DB, Alsop DC, et al (1994) MRI characterization of diffusion coefficients in a rat spinal cord injury model. Magn Reson Med 31:488–494

    PubMed  CAS  Google Scholar 

  10. Nevo U, Hauben E, Yoles E, et al (2001) Diffusion anisotropy MRI for quantitative assessment of recovery in injured rat spinal cord. Magn Reson Med 45:1–9

    Article  PubMed  CAS  Google Scholar 

  11. Schwartz ED, Yezierski RP, Pattany PM, Quencer RM, Weaver RG (1999) Diffusion-weighted MR imaging in a rat model of syringomyelia after excitotoxic spinal cord injury. Am J Neuroradiol 20:1422–1428

    PubMed  CAS  Google Scholar 

  12. Sagiuchi T, Tachibana S, Endo M, Hayakawa K (2002) Diffusion-weighted MRI of the cervical cord in acute spinal cord injury with type II odontoid fracture. J Comput Assist Tomogr 26:654–656

    Article  PubMed  Google Scholar 

  13. Schwartz ED, Chin CL, Takahashi M, Hwang SN, Hackney DB (2002) Diffusion-weighted imaging of the spinal cord. Neuroimaging Clin N Am 12:125–146

    Article  PubMed  Google Scholar 

  14. Demediuk P, Lemke M, Faden AI (1990) Spinal cord edema and changes in tissue content of Na+, K+, and Mg++ after impact trauma in rats. Adv Neurol 52:225–232

    PubMed  CAS  Google Scholar 

  15. Tator CH, Fehlings MG (1991) Review of secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms. J Neurosurg 75:15–26

    Article  PubMed  CAS  Google Scholar 

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We declare that we have no conflict of interest.

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Correspondence to Kazuhiro Tsuchiya.

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Tsuchiya, K., Fujikawa, A., Honya, K. et al. Value of diffusion-weighted MR imaging in acute cervical cord injury as a predictor of outcome. Neuroradiology 48, 803–808 (2006). https://doi.org/10.1007/s00234-006-0133-9

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  • DOI: https://doi.org/10.1007/s00234-006-0133-9

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