Imaging of Common Spinal Cord Diseases

Camilla Russo; Gianluca Muto; Flavio Giordano; Salvatore Masala; Mario Muto

doi:10.1055/s-0042-1755345

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2022; 26(04): 510-520
DOI: 10.1055/s-0042-1755345

Review Article

Imaging of Common Spinal Cord Diseases

Camilla Russo

¹Diagnostic and Interventional Neuroradiology Unit, Dipartimento delle Tecnologie Avanzate Diagnostico-Terapeutiche e dei Servizi sanitari, A.O.R.N. Cardarelli, Naples, Italy

²Department of Electrical Engineering and Information Technology (DIETI), Università Degli Studi di Napoli Federico II, Naples, Italy

,

Gianluca Muto

³Service de Radiologie, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland

,

Flavio Giordano

¹Diagnostic and Interventional Neuroradiology Unit, Dipartimento delle Tecnologie Avanzate Diagnostico-Terapeutiche e dei Servizi sanitari, A.O.R.N. Cardarelli, Naples, Italy

,

Salvatore Masala

⁴Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Università degli Studi di Roma Tor Vergata, Rome, Italy

,

Mario Muto

¹Diagnostic and Interventional Neuroradiology Unit, Dipartimento delle Tecnologie Avanzate Diagnostico-Terapeutiche e dei Servizi sanitari, A.O.R.N. Cardarelli, Naples, Italy

› Author Affiliations

Abstract

Spinal cord evaluation is an integral part of spine assessment, and its reliable imaging work-up is mandatory because even localized lesions may produce serious effects with potentially irreversible sequelae. Spinal cord alterations are found both incidentally during spine evaluation in otherwise neurologically asymptomatic patients or during neurologic/neuroradiologic assessment in myelopathic patients. Myelopathy (an umbrella term for any neurologic deficit that refers to spinal cord impairment) can be caused by intrinsic lesions or extrinsic mechanical compression, and its etiology may be both traumatic and/or nontraumatic. The symptoms largely depend on the size/extension of lesions, ranging from incontinence to ataxia, from spasticity to hyperreflexia, from numbness to weakness. Magnetic resonance imaging is the reference imaging modality in spinal cord evaluation, ensuring the best signal and spatial resolution. We provide an overview of the most common spinal cord disorders encountered by radiologists and describe the technical measures that offer optimal spinal cord visualization.

Keywords

central nervous system - spine - spinal cord - myelopathy - magnetic resonance imaging

Full Text

References

References
1 Pearce JMS. The development of spinal cord anatomy. Eur Neurol 2008; 59 (06) 286-291
2 Purves D, Augustine GJ, Fitzpatrick D. et al. The internal anatomy of the spinal cord. In: Purves D, Augustine GJ, Fitzpatrick D. et al, eds. Neuroscience. 2nd ed.. Sunderland, MA: Sinauer Associates; 2001
3 Gofur E, Singh P. Anatomy, back, vertebral canal blood supply. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing;
4 Wheeler-Kingshott CA, Stroman PW, Schwab JM. et al. The current state-of-the-art of spinal cord imaging: applications. Neuroimage 2014; 84: 1082-1093
5 Pierre-Jerome C, Arslan A, Bekkelund SI. MRI of the spine and spinal cord: imaging techniques, normal anatomy, artifacts, and pitfalls. J Manipulative Physiol Ther 2000; 23 (07) 470-475
6 Vargas MI, Boto J, Meling TR. Imaging of the spine and spinal cord: an overview of magnetic resonance imaging (MRI) techniques. Rev Neurol (Paris) 2021; 177 (05) 451-458
7 Do-Dai DD, Brooks MK, Goldkamp A, Erbay S, Bhadelia RA. Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review. Curr Probl Diagn Radiol 2010; 39 (04) 160-185
8 Chen Y, Haacke EM, Bernitsas E. Imaging of the spinal cord in multiple sclerosis: past, present, future. Brain Sci 2020; 10 (11) E857
9 Bammer R, Fazekas F, Augustin M. et al. Diffusion-weighted MR imaging of the spinal cord. AJNR Am J Neuroradiol 2000; 21 (03) 587-591
10 Holder CA, Muthupillai R, Mukundan Jr S, Eastwood JD, Hudgins PA. Diffusion-weighted MR imaging of the normal human spinal cord in vivo. AJNR Am J Neuroradiol 2000; 21 (10) 1799-1806
11 Hiremath SB, Boto J, Regnaud A, Etienne L, Fitsiori A, Vargas MI. Incidentalomas in spine and spinal cord imaging. Clin Neuroradiol 2019; 29 (02) 191-213
12 Martin AR, Aleksanderek I, Cohen-Adad J. et al. Translating state-of-the-art spinal cord MRI techniques to clinical use: a systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI. Neuroimage Clin 2015; 10: 192-238
13 Stroman PW, Cahill CM. Functional magnetic resonance imaging of the human spinal cord and brainstem during heat stimulation. Proc Intl Soc Mag Reson Med 2006; 14: 6-12
14 Vargas MI, Gariani J, Sztajzel R. et al. Spinal cord ischemia: practical imaging tips, pearls, and pitfalls. AJNR Am J Neuroradiol 2015; 36 (05) 825-830
15 Ellingson BM, Salamon N, Hardy AJ, Holly LT. Prediction of neurological impairment in cervical spondylotic myelopathy using a combination of diffusion MRI and proton MR spectroscopy. PLoS One 2015; 10 (10) e0139451
16 Hargreaves BA, Worters PW, Pauly KB, Pauly JM, Koch KM, Gold GE. Metal-induced artifacts in MRI. AJR Am J Roentgenol 2011; 197 (03) 547-555
17 Stradiotti P, Curti A, Castellazzi G, Zerbi A. Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art. Eur Spine J 2009; 18 (1, Suppl 1): 102-108
18 Levy LM, Di Chiro G, Brooks RA, Dwyer AJ, Wener L, Frank J. Spinal cord artifacts from truncation errors during MR imaging. Radiology 1988; 166 (02) 479-483
19 Marrodan M, Gaitán MI, Correale J. Spinal cord involvement in MS and other demyelinating diseases. Biomedicines 2020; 8 (05) 130
20 Miki Y. Magnetic resonance imaging diagnosis of demyelinating diseases: an update. Clin Exp Neuroimmunol 2019; 10 (S1): 32-48
21 Lee MJ, Aronberg R, Manganaro MS, Ibrahim M, Parmar HA. Diagnostic approach to intrinsic abnormality of spinal cord signal intensity. Radiographics 2019; 39 (06) 1824-1839
22 Bartels F, Lu A, Oertel FC, Finke C, Paul F, Chien C. Clinical and neuroimaging findings in MOGAD-MRI and OCT. Clin Exp Immunol 2021; 206 (03) 266-281
23 Montalvo M, Cho TA. Infectious myelopathies. Neurol Clin 2018; 36 (04) 789-808
24 Granados Sanchez AM, Garcia Posada LM, Ortega Toscano CA, Lopez Lopez A. Diagnostic approach to myelopathies. Rev Colomb Radiol 2011; 22 (03) 3231-3251
25 Agmon-Levin N, Kivity S, Szyper-Kravitz M, Shoenfeld Y. Transverse myelitis and vaccines: a multi-analysis. Lupus 2009; 18 (13) 1198-1204
26 Cree BAC. Acute inflammatory myelopathies. Handb Clin Neurol 2014; 122: 613-667
27 Nardone R, Versace V, Brigo F. et al. Herpes simplex virus type 2 myelitis: case report and review of the literature. Front Neurol 2017; 8: 199
28 Sotoca J, Rodríguez-Álvarez Y. COVID-19-associated acute necrotizing myelitis. Neurol Neuroimmunol Neuroinflamm 2020; 7 (05) e803
29 Grill MF. Infectious myelopathies. Continuum (Minneap Minn) 2018; 24 (2, Spinal Cord Disorders): 441-473
30 Krings T, Geibprasert S. Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30 (04) 639-648
31 Heldner MR, Arnold M, Nedeltchev K, Gralla J, Beck J, Fischer U. Vascular diseases of the spinal cord: a review. Curr Treat Options Neurol 2012; 14 (06) 509-520
32 Clark AJ, Wang DD, Lawton MT. Spinal cavernous malformations. In: Spetzler RF, Moon K, Almefty RO. eds. Handbook of Clinical Neurology. Philadelphia, PA: Elsevier; 2017: 303-308
33 Renieri L, Raz E, Lanzino G. et al. Spinal artery aneurysms: clinical presentation, radiological findings and outcome. J Neurointerv Surg 2018; 10 (07) 644-648
34 Gaur R, Mittal N, Joshi M, Dubey K. A rare study of electric shock associated spinal injuries: prognosis and outcome. Int J Contemp Med Res 2016; 3 (08) 2450-2453
35 Schwendimann RN. Metabolic and toxic myelopathies. Continuum (Minneap Minn) 2018; 24 (2, Spinal Cord Disorders): 427-440
36 Goodman BP. Metabolic and toxic causes of myelopathy. Continuum (Minneap Minn) 2015; 21 (1, Spinal Cord Disorders): 84-99
37 Galvin JE, Giasson B, Hurtig HI, Lee VM, Trojanowski JQ. Neurodegeneration with brain iron accumulation, type 1 is characterized by alpha-, beta-, and gamma-synuclein neuropathology. Am J Pathol 2000; 157 (02) 361-368
38 Lorenzi RM, Palesi F, Castellazzi G. et al. Unsuspected involvement of spinal cord in Alzheimer disease. Front Cell Neurosci 2020; 14: 6
39 Cools MJ, Al-Holou WN, Stetler Jr WR. et al. Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr 2014; 13 (05) 559-567
40 Fam MD, Woodroffe RW, Helland L. et al. Spinal arachnoid cysts in adults: diagnosis and management. A single-center experience. J Neurosurg Spine 2018; 29 (06) 711-719
41 Atesok K, Tanaka N, O'Brien A. et al. Posttraumatic spinal cord injury without radiographic abnormality. Adv Orthop 2018; 2018: 7060654
42 Boese CK, Müller D, Bröer R. et al. Spinal cord injury without radiographic abnormality (SCIWORA) in adults: MRI type predicts early neurologic outcome. Spinal Cord 2016; 54 (10) 878-883

Supplementary Material

Supplementary Material