Prognosis of cervical spinal cord injury in correlation with magnetic resonance imaging.
Magnetic resonance (MR) images of 18 patients with a cervical spinal cord injury were analysed for prognostic signs of paralysis. Serial MR images were obtained within 48 hours (acute stage), then 2 weeks (subacute stage) and an average of 12 months (range 6-24 months) after injury. The patterns of signal intensity in the acute stage were divided into two types, slightly-low/low (SL/L) type and slightly-low/high (SL/H) type on T1-weighted images (T1WI) and T2-weighted images (T2WI). The patterns in the subacute stage were divided into two types, high/high (H/H) type and normal/high (N/H) type on T1WI and T2WI. Six patients showed SL/L type in the acute stage and H/H type in the subacute stage. Five of the patients had a paralysis of grade A and one of grade B at admission which remained unchanged after treatment. One patient showed SL/H type in the acute stage and H/H type in the subacute stage. The patient had a paralysis of grade A that improved to no more than grade B. The remaining 11 patients showed SL/H type in the acute stage and N/H type in the subacute stage. Their paralysis was from grade B to D at admission and grade D or E at the follow up. The signal intensity of SL/L type in the acute stage and H/H type in the subacute stage are bad prognostic signs.
Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
T
T
Sato
S
S
Kokubun
K P
KP
Rijal
T
T
Ojima
N
N
Moriai
M
M
Hashimoto
H
H
Hyodo
H
H
Oonuma
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000473:pathology; D011379:Prognosis; D013116:Spinal Cord / Q000473:pathology; D013119:Spinal Cord Injuries / Q000473:pathology*