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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleSpine Imaging and Spine Image-Guided Interventions

The Early Evolution of Spinal Cord Lesions on MR Imaging following Traumatic Spinal Cord Injury

B.G. Leypold, A.E. Flanders and A.S. Burns
American Journal of Neuroradiology May 2008, 29 (5) 1012-1016; DOI: https://doi.org/10.3174/ajnr.A0962
B.G. Leypold
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A.E. Flanders
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A.S. Burns
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    Fig 1.

    Short-interval follow-up cervical MR imaging of a 67-year-old male ASIA A patient with SCI. T2-weighted FSE images were obtained from an initial MR imaging examination performed 9.5 hours after injury (A and C), as well as from a follow-up postreduction examination performed 55 hours after the first MR imaging (B and D). Demonstrated on the sagittal images (A and B) is a large increase in T2-hyperintense spinal cord edema (arrows demonstrate cranial-most extent), whereas representative axial images from the C5/C6 interspace (C and D) confirm the absence of cord edema at that level on the initial study, with the development of cord edema (arrow) on the second study.

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    Table 1:

    Length of cord edema in patients with short-interval follow-up MR imaging

    PatientAgeTime (h)Edema Length (U)Change in Length*Intervening Procedure
    Injury to MRI 1MRI 1 to MRI 2MRI 1MRI 2
    14623.5141214+2Closed reduction
    2838.25401216+4Closed reduction
    3679.555612+6Open reduction
    45837.5601015+5None
    58418.75110510+5Open reduction
    • * Paired t test demonstrates a significant increase (t = −6.5, P = .003) in edema length. Mean change in edema length was 4.4 U (95% CI, 2.5–6.3).

    • View popup
    Table 2:

    Demographic and clinical characteristics of 48 ASIA A patients

    Characteristic
    Mean age (yr)47.1 ± 21.7
    Sex
        Male39
        Female9
    Neurologic level of injury
        C422
        C517
        C69
    Time from injury to MR imaging (h)
        Range2.5–66.25
        Mean18.8 ± 14.9
    • View popup
    Table 3:

    Spinal cord lesion characteristics on MR imaging

    Characteristic
    Patients with spinal cord
        Edema48/48 (100%)
        Hemorrhage32/48 (67%)
    Mean length
        Cord edema (units)10.3 ± 4.0
        Cord hemorrhage (units)2.6 ± 2.0
    • View popup
    Table 4:

    Results of multiple regression analysis to examine the effect of time to imaging on edema length

    VariableCoefficientStandard Error*P value
    Intercept10.91.4.001
    Time to MR imaging0.1080.034.002
    Age−0.0650.023.008
    Sex2.51.3.06
    • * Standard error of the estimated coefficient.

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American Journal of Neuroradiology: 29 (5)
American Journal of Neuroradiology
Vol. 29, Issue 5
May 2008
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The Early Evolution of Spinal Cord Lesions on MR Imaging following Traumatic Spinal Cord Injury
B.G. Leypold, A.E. Flanders, A.S. Burns
American Journal of Neuroradiology May 2008, 29 (5) 1012-1016; DOI: 10.3174/ajnr.A0962
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B.G. Leypold, A.E. Flanders, A.S. Burns
The Early Evolution of Spinal Cord Lesions on MR Imaging following Traumatic Spinal Cord Injury
American Journal of Neuroradiology May 2008, 29 (5) 1012-1016; DOI: 10.3174/ajnr.A0962

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