ASNR22/SNR XXII Proceedings
Purpose Compressive non-neoplastic spinal cord lesions represent a broad spectrum of neurologic disease processes contributing to back pain and neuropathy, including traumatic, inflammatory/infectious, degenerative, and metastatic etiologies. Compressive cord lesions are optimally evaluated with high-field strength magnet MRI with and without contrast. Differential diagnoses for cord lesions are inherently broad due to the nonspecific nature of increased intramedullary signal on T2-weighted images seen with many cord pathologies. However, differentiating features such as degree of cord expansion, enhancement characteristics, and extramedullary findings can provide additional information to refine the differential diagnosis. In this exhibit, we present representative cases of compressive non-neoplastic spinal cord lesions from our institutional archive, outlined accordingly: traumatic (traumatic spondylolisthesis with cord contusion, epidural hematoma), infectious/inflammatory (epidural abscess), degenerative (disk herniation, spinal stenosis), and metastatic (osseous metastasis with cord compression). These cases will be presented according to our institutional protocol: sagittal T1, sagittal T2, sagittal STIR, axial T2*, axial T2, axial T1 without and with contrast, and diffusion weighted imaging. Each case will include brief literature review with discussion points. Objectives -Review common spinal cord lesions under the category of compressive, non-neoplastic. -Characterize compressive non-neoplastic cord lesions according to anatomic distribution, MRI signal characteristics, enhancement patterns, and relationship to symptom onset and clinical presentation. Materials and Methods N/A Results N/A Conclusions Disease processes relating to compressive non-neoplastic spinal cord lesions are numerous and often difficult to delineate from one another. A thorough knowledge of pathologies within this category, along with key imaging findings to differentiate these pathologies, can aid the radiologist in developing a practical and accurate differential diagnosis, ultimately leading to better patient outcomes
Dearden A, Ghannam J, Wang A, Krishnan A. Neuroimaging spectrum of compressive non-neoplastic myelopathy. ASNR22/SNR XXII Proceedings. 2022 May 16-18:570.