Evaluation of t2 hyperintensities in spinal cord lesions using magnetic resonance protocol - a one year observational study at tertiary care hospital in north karnataka

Abstract

Myelopathy is the major cause of quadriplegia and disability. Many spinal cord abnormalities are reversible if recognized and treated at an early stage. Plain radiographs have low sensitivity in identification of demyelinating / neoplastic spinal lesions. The role of MRI is to distinguish compressive from non- compressive causes of myelopathy. Spinal cord biopsy is a high-risk procedure with the potential to cause permanent neurological injury. Magnetic resonance imaging is the modality of choice for diagnosis and preoperative assessment of patients with spinal cord abnormalities. One of the most common finding in imaging is either focal or diffuse hyperintensity on T2 weighted MR images. Intramedullary T2 hyperintensity pose a serious dilemma in imaging because it has a wide range of causes such as MR artifacts, trauma, primary and secondary tumors, multiple sclerosis, subacute combined degeneration of the spinal cord, transverse myelitis, neurosarcoidosis and syringohydromyelia. The objective of this study is to approach systematically which incorporates detailed clinical history, acuity of symptoms, distribution of the signal abnormalities, including length of cord involvement and the area that is affected which helps narrowing down the list of differential diagnosis and improve the treatment outcomes.