Spinal cord edema: unusual magnetic resonance imaging findings in cervical spondylosis
Spinal cord edema: unusual magnetic resonance imaging findings in cervical spondylosis
复制标题
DOI：
10.3171/spi.2003.99.1.0008
复制
发表时间：
2003-07-01
影响因子：
4.1
通讯作者：
Mitsumori, K
中科院分区：
文献类型：
--
作者：
Lee, J;Koyanagi, I;Mitsumori, K
Object.脊髓水肿是一种罕见的放射学发现慢性退行性疾病的脊柱。在1997年至2001年期间，作者治疗了6例脊髓型颈椎病患者，这些患者术后出现脊髓水肿。作者描述了这种不寻常的情况下的放射学和临床特征。6例患者均为男性，年龄44 ~ 72岁。所有患者均表现为轻度四肢轻瘫，并接受了椎板成形术或前路融合术。术前磁共振（MR）成像显示明显的脊髓压迫与髓内高信号的T-2加权序列和脊髓增强后，在管理的Gd的压缩水平。手术后，脊髓水肿观察所有患者，脊髓出现肿胀的术后MR图像。术前和术后Gd增强MR成像显示压缩节段的白色物质明显增强。神经功能方面，6例患者中有5例患者的症状得到了良好的改善;然而，随访MRI显示脊髓水肿在术后持续数月。脊髓水肿的放射学特征是基于可逆性白色病变，最有可能是由慢性脊髓压迫引起的局部静脉循环紊乱引起的。脊髓型颈椎病的这种不寻常的MR表现应与脊髓髓内肿瘤、脱髓鞘疾病或炎性病变相鉴别。
Object. Spinal cord edema is a rare radiological finding in chronic degenerative disorders of the spine. Between 1997 and 2001, the authors treated six patients with cervical spondylotic myelopathy in whom postoperative spinal cord edema was demonstrated. The authors describe the radiological and clinical features of this unusual condition.Methods. The six patients were all men, and ranged in age from 44 to 72 years. All patients presented with mild quadriparesis and underwent laminoplasty or anterior fusion. Preoperative magnetic resonance (MR) imaging revealed marked spinal cord compression with intramedullary hyperintensity on T-2-weighted sequences and spinal cord enhancement at the compression level after administration of Gd.After surgery, spinal cord edema was observed in all patients; the spinal cord appeared swollen on the postoperative MR images. Preoperative and postoperative Gd-enhanced MR imaging demonstrated clear enhancement of the white matter at the compressed segment. Neurologically, five of six patients experienced good improvement of symptoms; however, the spinal cord edema as documented on follow-up MR imaging persisted for several months after surgery.Conclusions. The radiological characterization of spinal cord edema was based on the reversible white matter lesion most likely caused by disturbed local venous circulation induced by chronic spinal cord compression. Such unusual MR findings in cervical spondylotic myelopathy should be differentiated from intramedullary spinal cord tumors, demyelinating disorders, or inflammatory processes.