Kasat Paschyanti R, Kashikar Shivali V, Parihar Pratapsingh, Sachani Pratiksha, Shrivastava Priyal, Mapari Smruti A, Pradeep Utkarsh, Bedi Gautam N, Bhangale Paritosh N
Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2024 Sep 24;16(9):e70110. doi: 10.7759/cureus.70110. eCollection 2024 Sep.
Metastatic epidural spinal cord compression (MESCC) is a critical oncologic emergency caused by the invasion of metastatic tumors into the spinal epidural space, leading to compression of the spinal cord. If not promptly diagnosed and treated, MESCC can result in irreversible neurological deficits, including paralysis, significantly impacting the patient's quality of life. Early detection and timely intervention are crucial to prevent permanent damage. Imaging modalities play a pivotal role in the diagnosis, assessment of disease extent, and treatment planning for MESCC. Magnetic resonance imaging (MRI) is the current gold standard due to its superior ability to visualize the spinal cord, epidural space, and metastatic lesions. However, recent advances in imaging technologies have enhanced the detection and management of MESCC. Innovations such as functional MRI, diffusion-weighted imaging (DWI), and hybrid techniques like positron emission tomography-computed tomography (PET-CT) and PET-MRI have improved the accuracy of diagnosis, particularly in detecting early metastatic changes and guiding therapeutic interventions. This review provides a comprehensive analysis of the evolution of imaging techniques for MESCC, focusing on their roles in detection, diagnosis, and treatment planning. It also discusses the impact of these advances on clinical outcomes and future research directions in imaging modalities for MESCC. Understanding these advancements is critical for optimizing the management of MESCC and improving patient prognosis.
转移性硬膜外脊髓压迫症（MESCC）是一种严重的肿瘤急症，由转移性肿瘤侵入脊髓硬膜外间隙导致脊髓受压引起。如果不及时诊断和治疗，MESCC可导致不可逆的神经功能缺损，包括瘫痪，严重影响患者的生活质量。早期发现和及时干预对于预防永久性损伤至关重要。影像学检查在MESCC的诊断、疾病范围评估和治疗规划中起着关键作用。磁共振成像（MRI）因其在显示脊髓、硬膜外间隙和转移性病变方面的卓越能力，是目前的金标准。然而，影像学技术的最新进展提高了MESCC的检测和管理水平。诸如功能MRI、扩散加权成像（DWI）以及正电子发射断层扫描-计算机断层扫描（PET-CT）和PET-MRI等混合技术等创新，提高了诊断的准确性，特别是在检测早期转移变化和指导治疗干预方面。本综述对MESCC成像技术的发展进行了全面分析，重点关注它们在检测、诊断和治疗规划中的作用。它还讨论了这些进展对临床结果的影响以及MESCC成像模式的未来研究方向。了解这些进展对于优化MESCC的管理和改善患者预后至关重要。
