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Research ArticleSpine Imaging and Spine Image-Guided Interventions

Peripheral Spinal Cord Hypointensity on T2-weighted MR Images: A Reliable Imaging Sign of Venous Hypertensive Myelopathy

Robert W. Hurst and Robert I. Grossman
American Journal of Neuroradiology April 2000, 21 (4) 781-786;
Robert W. Hurst
aFrom the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
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Robert I. Grossman
aFrom the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
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Abstract

BACKGROUND AND PURPOSE: MR findings reported in conjunction with spinal dural arteriovenous fistula (SDAVF) include cord swelling, increased T2 signal within the spinal cord, and parenchymal enhancement, each of which is nonspecific. Enlarged vessels on the cord surface, the most specific MR finding, is noted in only half of SDAVF patients. Nevertheless, we have frequently observed MR peripheral hypointensity of the spinal cord in SDAVF on T2-weighted images, which is not characteristic of nonvascular or nonhemorrhagic causes of myelopathy and which has not been described in association with SDAVF. We hypothesized that peripheral cord hypointensity might reliably suggest the diagnosis of SDAVF or other causes of venous hypertensive myelopathy.

METHODS: We reviewed the MR findings in 11 consecutive cases of angiographically confirmed symptomatic SDAVF and in four cases of intracranial dural arteriovenous fistula with spinal drainage, a lesion that also causes spinal cord deficits mediated by venous hypertensive myelopathy.

RESULTS: In each case, T2 hypointensity involving the cord periphery was present. This sign has not been previously described in association with either SDAVF or other causes of venous hypertensive myelopathy. It appears, however, to be a relatively constant imaging feature of SDAVF.

CONCLUSION: In the absence of spinal hemorrhage, T2 hypointensity involving the periphery of the spinal cord suggests venous hypertensive myelopathy as a cause of spinal cord dysfunction.

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American Journal of Neuroradiology
Vol. 21, Issue 4
1 Apr 2000
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Cite this article
Robert W. Hurst, Robert I. Grossman
Peripheral Spinal Cord Hypointensity on T2-weighted MR Images: A Reliable Imaging Sign of Venous Hypertensive Myelopathy
American Journal of Neuroradiology Apr 2000, 21 (4) 781-786;

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Peripheral Spinal Cord Hypointensity on T2-weighted MR Images: A Reliable Imaging Sign of Venous Hypertensive Myelopathy
Robert W. Hurst, Robert I. Grossman
American Journal of Neuroradiology Apr 2000, 21 (4) 781-786;
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