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논문 상세정보

횡단성 척수염의 자기공명영상소견 : T2강조영상을 중심으로

MR Findings of Transverse Myelitis : Focusing on T2WI


Purpose : The purpose of this study is to describe the MR findings of transverse myelitis, especially on T2weighted images and to determine if there are any MR findings characteristic of transverse myelitis that may bevaluale in the differentiation from intramedullary tumor. Materials and Methods : The MR images of 13 patientswith the diagnosis of transverse myelitis were retrospectively reviewed. The diagnosis was based on both theclinical and follow-up MR images, and was confirmed by open biopsy in four patients. The MR features were analyzedin terms of the the position and extent of the lesion, signal intensity on all sequences, enhancementpatterns(nodular, patchy, linear, punctate, ring, and mixed), and the presence or absence of hemorrhage, cyst, andsyrinx. On T2-weighted images, existence of focal abnormal signal areas compatible with the enhancing lesions andshape of both rostral and caudal ends of the lesions were also evaluated. Results : On MR images, there wasfusiform swelling of the spinal cord over variable length from 2 to 10 vertebral segments. The lesions showeddiffuse isosignal intensity on T1 weighted images and high signal intensity on T2 weighted images. Contrast-enhanced T1 weighted images revealed variable enhacement pa- tterns ; nodular in 7, patchy in 6, linear in 3, punctate in 2, ring in 1 and mixed in 6 cases. The enhancement occurred usually within the central portion of highsignal intensity lesion of the swollen cord. The cranial and caudal ends of the high signal lesion usually showedsmooth tapered appearance in 12 cases(both ends in 10 and one end in 2). There was no focal abnormal signal lesioncompatible with the enhancing area. No case demon- strated any hemorrhage, cyst, and syrinx. Conclusion :Segmental cord swelling, diffuse high signal intensity with tapered appearance of both cranial and caudal ends, and no focal abnormal signal intensity that is compatible with the enhancing lesion, suggest transverse myelitis.Therefore, if above MR findings are seen, follow-up study is recom- mended to avoid the invasive surgicalprocedures.

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