Acute Spinal Cord Infarction: Diffusion-Weighted MR Imaging - Case Report -

Hyun Duk Yang; Sung Kyun Oh; Dae Moo Shim

doi:10.4184/jkss.2013.20.2.64

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Yang, Oh, and Shim: Acute Spinal Cord Infarction: Diffusion-Weighted MR Imaging - Case Report -

Case Report

Journal of Korean Spine Surg 2013;20(2):64-66.

Published online: 21 June 2013

DOI: https://doi.org/10.4184/jkss.2013.20.2.64

Acute Spinal Cord Infarction: Diffusion-Weighted MR Imaging - Case Report -

Hyun Duk Yang, M.D.^∗, Sung Kyun Oh, M.D., Dae Moo Shim, M.D.

Department of Orthopedic Surgery, School of Medicine, Wonkwang University, Iksan, Korea

^∗Department of Neurology, School of Medicine, Wonwang University, Gunpo, Korea

Institute of Wonkwang Medical Science, Iksan, Korea

Corresponding author: Sung Kyun Oh, M.D. Department of Orthopedic Surgery, School of Medicine, Wonkwang University Sanbon Hospital, Sanbondong, Gunpo city, Gyeongido, Korea TEL: 82-31-390-2992, FAX: 82-31-390-2244 E-mail: niceo@hanmail.net

Received 15 May 2012 Revised 13 July 2012 Accepted 8 December 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Objective

We present a rare case of acute spinal cord infarction and usefulness of diffusion weighted MR imaging.

Summary of Literature Review

T1-weighted and T2-weighted images are often normal in a patient with acute spinal cord infarction.

Material and Methods

An 82-year-old presented with acute onset of paraplegia and urinary retention. His symptoms developed 6 days ago without any trauma. He had a history of vertebroplasty due to compression fracture of 12th thoracic vertebral body 6 years ago. There was no evidence of spinal cord compression on routine T1-and T2-weighted MRI.

Results

In diffusion-weighted MRI, a high intensity signal intensity lesion in the spinal cord and conus medullaris was observed.

Conclusion

We report an example for the usefulness of diffusion-weighted image for early and accurate diagnosis of acute spinal cord infarction.

Keywords: Spinal cord, Infarction, Diffusion-MRI

REFERENCES

1. Loher TJ, Bassetti CL, Lö vblad KO, et al. Diffusion-weight-ed MRI in acute spinal cord ischaemia. Neuroradiology. 2003; 45:557–61.

2. Thurnher MM, Bammer R. Diffusion-weighted MR imaging (DWI) in spinal cord ischemia. Neuroradiology. 2006; 48:795–801.

3. Weidauer S, Nichtweiss M, Lanfermann H, Zanella FE. Spinal cord infarction: MR imaging and clinical features in 16 cases. Neuroradiology. 2002; 44:851–7.

4. Zhang J, Huan Y, Qian Y, Sun L, Ge Y. Multishot diffusion-weighted imaging features in spinal cord infarction. J Spinal Disord Tech. 2005; 18:277–82.

5. de Figueiredo EH, Borgonovi AF, Doring TM. Basic con-cepts of MR imaging, diffusion MR imaging, and diffusion tensor imaging. Magn Reson Imaging Clin N Am. 2011; 19:1–22.

6. El-Koussy M, Lö vblad KO, Kiefer C, et al. Apparent diffusion coefficient mapping of infarcted tissue and the ischaemic penumbra in acute stroke. Neuroradiology. 2002; 44:812–8.

Fig. 1.

(A) T2-weighted sagittal image shows a strip like intramedullary high-signal intensity in the spinal cord. (B) and T1-weighted image shows no remarkable signal changes in the cord. (C) An axial T2-weighted image at the level of T12 show an symmetric intramedullary hyperintensy lesion. (D) An axial T1-weighted image at the level of T12 shows no abnormal signal changes.

Fig. 2.

(A) A sagittal diffusion-weighted image shows marked high signal intensity lesion at the corresponding area at the level of T12 (arrow) (B) The apparent diffusion coefficient (ADC) map image shows a low-signal intensity at the same area (arrow)

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