Inflammation, infection, cavitary disorders, and ischemia.
Demyclinating lesions of the spinal cord, including multiple sclerosis as well as other less common diseases, probably represent the etiology of a substantial proportion of all idiopathic myelopathies. Magnetic resonance imaging (MRI) has made major advances in the diagnosis and characterization of demyclinating disease. Infections of the spine may have severe consequences and, if detected early, are usually treatable processes. Osteomyelitis and epidural abscesses have characteristic imaging findings. Poor outcomes are more often due to delays in clinical presentation or the debilitated condition of the patients than to limitations in the accuracy of MRI diagnosis. Cavitary lesions of the spinal cord were among the first applications in which MRI proved its superiority to previously available techniques. Accurate diagnosis of these lesions involves detecting characteristics findings and relating these observations to the clinical history. Spinal cord infarction is relatively rare due to the extensively collateralized blood supply to the spinal canal. However, aortic aneurysms and the surgery for these lesions places the blood supply of the distal spinal cord and conus at risk. The syndrome of postoperative spinal cord infarction has characteristic clinical findings. However, MRI may contribute to distinguishing transient ischemia from true infarction and to predicting the severity of the final deficit.
Hackney
D B
DB
Department of Radiology, University of Pennsylvania, Philadelphia.
D003711:Demyelinating Diseases / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000175:diagnosis; D013118:Spinal Cord Diseases / Q000175:diagnosis*; D013122:Spinal Diseases / Q000175:diagnosis*