Dinca-Avarvarei L, Valdés-Cruces J C, Quesada-García M, Izquierdo G
Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Rev Neurol. 2005;40(5):282-5.
The diagnosis of ischemic lesions affecting the spinal cord is sometimes difficult to confirm using conventional magnetic resonance imaging (MRI) techniques, and this makes it necessary to use those currently available to their full extent and also to search for new ones.
We report the case of an 81-year-old male patient who presented symptoms of sudden onset paraparesis, secondary to lesions in the anterior spinal territory and whose diagnosis was reached using conventional spinal cord MRI, and later confirmed with the diffusion imaging technique. Diffusion MRI in the spinal cord territory, as well as in the brain territory, is a very interesting first choice technique when an ischemic pathology is suspected. Using only T2-weighted images does not allow acute ischemic lesions to be distinguished from chronic lesions; likewise, intramedullary T2 hyperintensity and standard DWI (Diffusion Weighted Imaging) is not specific to acute spinal ischemia, and the determination of the apparent diffusion coefficient in the lesion may help in the differential diagnosis of diseases affecting the spinal cord.
Including diffusion RMI techniques in the study protocols in cases of ischemic spinal cord pathologies is indispensable today if we hope to reach a fast and correct diagnosis.
使用传统磁共振成像(MRI)技术有时难以确诊影响脊髓的缺血性病变,这使得有必要充分利用现有的技术,并探索新的技术。
我们报告了一例81岁男性患者,该患者因脊髓前区病变出现突发双下肢轻瘫症状,最初通过传统脊髓MRI诊断,后来通过扩散成像技术得以证实。当怀疑存在缺血性病变时,脊髓区域以及脑区的扩散MRI是一种非常值得首选的技术。仅使用T2加权图像无法区分急性缺血性病变和慢性病变;同样,脊髓内T2高信号和标准扩散加权成像(DWI)并非急性脊髓缺血所特有,病变表观扩散系数的测定可能有助于脊髓疾病的鉴别诊断。
如果我们希望快速、准确地做出诊断,如今在缺血性脊髓病变的研究方案中纳入扩散MRI技术是必不可少的。