Choi K H, Lee K S, Chung S O, Park J M, Kim Y J, Kim H S, Shinn K S
Department of Radiology, Kangman St Mary's Hospital, Catholic University Medical College, Seocho-Ku, Seoul, Korea.
AJNR Am J Neuroradiol. 1996 Jun-Jul;17(6):1151-60.
To describe the MR characteristics that can distinguish idiopathic transverse myelitis from other intramedullary lesions.
A total of 32 initial and follow-up MR studies in 17 patients with clinically proved transverse myelitis were reviewed retrospectively. The location, size, pattern, and segmental length of areas of hyperintensity were estimated on T2-weighted axial and sagittal images. In 15 of the patients, whose neurologic abnormalities were limited to the spinal cord, the location and pattern of intramedullary contrast enhancement were evaluated on sagittal and axial T1-weighted images. Follow-up MR studies were available for 10 patients. The statistical significance of cord enhancement between the groups with and without cord expansion was calculated.
Common MR findings of idiopathic transverse myelitis included a centrally located hyperintensity occupying more than two thirds of the cross-sectional area of the cord (88%); a length of 3 to 4 vertebral segments (53%), with variable presence of cord expansion (47%); a small central area of intensity, isointense with normal cord, in the core of hyperintensity (47%); focal, peripheral cord enhancement (53%), particularly in patients with cord expansion; and a slow regression of T2 hyperintensity with an enhancing nodule. Although no linear correspondence was observed between MR findings and neurologic signs and symptoms, all but 4 patients improved clinically as MR findings improved or remained stable.
MR findings are helpful in detecting transverse myelitis and in differentiating this entity from multiple sclerosis and cord tumors, but clinical assessment and observation of MR changes over time are essential in making the diagnosis.
描述可将特发性横贯性脊髓炎与其他髓内病变相鉴别的磁共振成像（MR）特征。
回顾性分析17例临床确诊为横贯性脊髓炎患者的32份初次及随访MR研究资料。在T2加权轴位和矢状位图像上评估高信号区域的位置、大小、形态及节段长度。15例神经功能异常局限于脊髓的患者，在矢状位和轴位T1加权图像上评估髓内对比增强的位置和形态。10例患者有随访MR研究资料。计算脊髓增粗组与未增粗组之间脊髓强化的统计学意义。
特发性横贯性脊髓炎常见的MR表现包括：中央性高信号占据脊髓横截面积的三分之二以上（88%）；长度为3至4个椎体节段（53%），可有不同程度的脊髓增粗（47%）；在高信号核心区有一小片与正常脊髓等信号的中央区（47%）；局灶性、周边脊髓强化（53%），尤其是脊髓增粗的患者；T2高信号缓慢消退并伴有强化结节。虽然未观察到MR表现与神经体征和症状之间存在线性对应关系，但除4例患者外，所有患者的临床症状均随MR表现改善或保持稳定而好转。
MR表现有助于检测横贯性脊髓炎，并将其与多发性硬化和脊髓肿瘤相鉴别，但临床评估以及对MR随时间变化的观察对于做出诊断至关重要。
