Weidauer Stefan, Nichtweiß Michael, Hattingen Elke, Berkefeld Joachim
Department of Neurology, Sankt Katharinen Hospital, Teaching Hospital of the Goethe - University, Frankfurt / Main, Seckbacher Landstraße 65, D 60389, Frankfurt / Main, Germany,
Neuroradiology. 2015 Mar;57(3):241-57. doi: 10.1007/s00234-014-1464-6. Epub 2014 Nov 16.
The purpose of this study was to analyse MR imaging features and lesion patterns as defined by compromised vascular territories, correlating them to different clinical syndromes and aetiological aspects.
In a 19.8-year period, clinical records and magnetic resonance imaging (MRI) features of 55 consecutive patients suffering from spinal cord ischemia were evaluated.
Aetiologies of infarcts were arteriosclerosis of the aorta and vertebral arteries (23.6%), aortic surgery or interventional aneurysm repair (11%) and aortic and vertebral artery dissection (11%), and in 23.6%, aetiology remained unclear. Infarcts occurred in 38.2% at the cervical and thoracic level, respectively, and 49% of patients suffered from centromedullar syndrome caused by anterior spinal artery ischemia. MRI disclosed hyperintense pencil-like lesion pattern on T2WI in 98.2%, cord swelling in 40%, enhancement on post-contrast T1WI in 42.9% and always hyperintense signal on diffusion-weighted imaging (DWI) when acquired.
The most common clinical feature in spinal cord ischemia is a centromedullar syndrome, and in contrast to anterior spinal artery ischemia, infarcts in the posterior spinal artery territory are rare. The exclusively cervical location of the spinal sulcal artery syndrome seems to be a likely consequence of anterior spinal artery duplication which is observed preferentially here.
本研究旨在分析由血管区域受损所定义的磁共振成像（MR）特征及病变模式，并将它们与不同的临床综合征和病因学方面进行关联。
在19.8年的时间里，对55例连续的脊髓缺血患者的临床记录和磁共振成像（MRI）特征进行了评估。
梗死的病因包括主动脉和椎动脉动脉硬化（23.6%）、主动脉手术或介入性动脉瘤修复（11%）以及主动脉和椎动脉夹层（11%），23.6%的患者病因仍不明确。梗死分别发生在颈段和胸段的比例为38.2%，49%的患者患有由脊髓前动脉缺血引起的中央脊髓综合征。MRI显示，98.2%的患者在T2加权成像（T2WI）上呈现高信号铅笔状病变模式，40%的患者脊髓肿胀，42.9%的患者在增强后T1加权成像（T1WI）上有强化，且在进行弥散加权成像（DWI）时始终为高信号。
脊髓缺血最常见的临床特征是中央脊髓综合征，与脊髓前动脉缺血不同，脊髓后动脉区域的梗死很少见。脊髓沟动脉综合征仅发生在颈部，这似乎是脊髓前动脉重复现象的一个可能结果，而这种现象在此处更为常见。
