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Diffusion-weighted MRI in acute spinal cord ischaemia

Loher, T. ; Bassetti, C. ; Lövblad, K. ; Stepper, F. ; Sturzenegger, M. ; Kiefer, C. ; Nedeltchev, K. ; Arnold, M. ; Remonda, L. ; Schroth, G.

In: Neuroradiology, 2003, vol. 45, no. 8, p. 557-561

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    Title
    • Diffusion-weighted MRI in acute spinal cord ischaemia
    Author
    • Loher, T.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Bassetti, C.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Lövblad, K.. Department of Neuroradiology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Stepper, F.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Sturzenegger, M.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Kiefer, C.. Department of Neuroradiology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Nedeltchev, K.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Arnold, M.. Department of Neurology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Remonda, L.. Department of Neuroradiology, Inselspital, University of Berne, 3010, Berne, Switzerland
    • Schroth, G.. Department of Neuroradiology, Inselspital, University of Berne, 3010, Berne, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:321781
    Summary
    Abstract : 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 54-75years with clinically suspected acute spinal cord ischaemia. Imaging was performed 9-46h after the onset of symptoms, and 2-9days 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