Tartaglino L M, Croul S E, Flanders A E, Sweeney J D, Schwartzman R J, Liem M, Amer A
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Radiology. 1996 Dec;201(3):661-9. doi: 10.1148/radiology.201.3.8939212.
To analyze the magnetic resonance (MR) imaging findings in idiopathic acute transverse myelitis (IATM) in relation to pathologic findings and MR findings in Guillain-Barré syndrome and ischemia.
The cases of 19 patients with IATM seen over a 4-year period were retrospectively reviewed. Clinical parameters and laboratory test findings were recorded for each patient independently of the MR findings.
Ten (53%) patients experienced upper respiratory infection or vaccination within 4 weeks of symptom onset. The majority (82%) of cases occurred between December and May each year. In seven of 12 patients who underwent electromyography and nerve conduction examinations, evidence of peripheral nerve injury was seen. On T2-weighted axial images, 13 of 18 lesions were depicted with holocord abnormal signal intensity, seven (39%) had gray matter involvement similar to that seen in spinal cord ischemia, and three (16%) had isolated white matter involvement. Enhancement patterns varied. In three (17%) of the 18 lesions, enhancement in the cauda equina was similar to that seen in Guillain-Barré syndrome.
IATM may be caused by a small vessel vasculopathy. MR findings in IATM also occasionally are similar to those described in Guillain-Barré syndrome and suggest a possible relationship.
分析特发性急性横贯性脊髓炎（IATM）的磁共振（MR）成像表现，并与格林-巴利综合征和缺血的病理表现及MR表现进行对比。
回顾性分析4年间收治的19例IATM患者的病例。独立于MR表现记录每位患者的临床参数和实验室检查结果。
10例（53%）患者在症状出现后4周内有上呼吸道感染或接种疫苗史。大多数病例（82%）发生在每年的12月至次年5月。在12例行肌电图和神经传导检查的患者中，7例有周围神经损伤的证据。在T2加权轴位图像上，18个病灶中有13个表现为全脊髓异常信号强度，7个（39%）灰质受累情况与脊髓缺血相似，3个（16%）仅白质受累。强化方式各异。18个病灶中有3个（17%）马尾强化情况与格林-巴利综合征相似。
IATM可能由小血管血管病变引起。IATM的MR表现偶尔也与格林-巴利综合征相似，提示可能存在关联。
