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Diffusion-weighted imaging in acute demyelinating myelopathy

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Diffusion-weighted imaging (DWI) has become a reference MRI technique for the evaluation of neurological disorders. Few publications have investigated the application of DWI for inflammatory demyelinating lesions. The purpose of the study was to describe diffusion-weighted imaging characteristics of acute, spinal demyelinating lesions.

Methods

Six consecutive patients (two males, four females; aged 28–64 years) with acute spinal cord demyelinating lesions were studied in a prospective case series design from June 2009 to October 2010. We performed magnetic resonance imaging studies from 2 to 14 days from symptom onset on the patients with relapsing remitting multiple sclerosis (n = 3) or clinically isolated syndrome (n = 3). Main outcome measures were diffusion-weighted imaging and apparent diffusion coefficient pattern (ADC) of acute spinal cord demyelinating lesions.

Results

All spinal lesions showed a restricted diffusion pattern (DWI+/ADC−) with a 24% median ADC signal decrease. A good correlation between clinical presentation and lesion site was observed.

Conclusion

Acute demyelinating spinal cord lesions show a uniform restricted diffusion pattern. Clinicians and neuro-radiologists should be aware that this pattern is not necessarily confirmatory for an ischaemic aetiology.

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Acknowledgements

The authors thank Liliane Petrini (Ph.D.) for her help in finalizing the manuscript.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Servizio di Neurologia e Neuroradiologia, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, via Tesserete 46, 6903, Lugano, Switzerland

    Chiara Zecca, Carlo Cereda, Silvia Tschuor, Claudio Staedler, Navarajah Nadarajah, Claudio L. Bassetti & Claudio Gobbi

  2. Abteilung für Neuroradiologie, Hirslanden Klinik Zürich, Swiss Neuro Institute (SNI), Zürich, Switzerland

    Stephan Wetzel

  3. Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland

    Francesco Santini

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  1. Chiara Zecca
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  2. Carlo Cereda
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  4. Silvia Tschuor
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Correspondence to Chiara Zecca.

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Zecca, C., Cereda, C., Wetzel, S. et al. Diffusion-weighted imaging in acute demyelinating myelopathy. Neuroradiology 54, 573–578 (2012). https://doi.org/10.1007/s00234-011-0907-6

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  • DOI: https://doi.org/10.1007/s00234-011-0907-6

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