Document Type

Conference Proceeding

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Publication Title

ASNR22/SNR XXII Proceedings


Purpose Non-compressive, non-neoplastic spinal cord lesions represent a broad range of disease processes and entities. Most commonly, spinal cord lesions demonstrate T2 signal abnormality on magnetic resonance imaging, a relatively nonspecific finding requiring a variety of differentiating factors to build an accurate differential diagnosis (1). Additionally, many disease entities have significant overlapping features on MRI, rendering it difficult to separate diagnoses and guide management (2). The combination of signal characteristics on MRI, timing of clinical presentation, degree of cord expansion, and contrast enhancement patterns can provide improved differentiation between disease entities. The purpose of this exhibit is to educate the viewer on radiographic findings of noncompressive, non-neoplastic spinal cord lesions, including common and rare clinical and radiological presentations. Building an accurate and complete differential diagnosis can aid in guiding therapy and preventing additional unnecessary work-up. Materials and Methods 1. To review common pathologies of non-compressive, non-neoplastic spinal cord lesions. 2. Characterize lesions based on anatomic distribution, signal intensity pattern, contrast enhancement, and their relationship to clinical onset and presentation. 3. Identify common pitfalls when imaging non-compressive, non-neoplastic spinal cord lesions. Results This exhibit will include presentations of non-compressive non-neoplastic spinal cord lesions and the distinguishing factors on magnetic resonance imaging, with CT and angiographic correlation as well. Cases will include congenital causes, demyelinating disease, longitudinally extensive transverse myelitis (ADEM, Anti-MOG), vascular disease (cord edema, cavernous cord infarction, AV fistula, etc.), post-traumatic etiologies, inflammatory/infectious disease, demyelinating disease, and metabolic myelopathy (vitamin B12 deficiency). Literature review and discussion points will accompany each case presentation in the respective categories. Conclusions Multiple clinical presentations of non-neoplastic spinal cord lesions exist, which have unique radiological findings. Familiarity with the neuroimaging findings within the non-compressive pathologic spectrum of non-neoplastic myelopathy can provide timely diagnoses to facilitate appropriate management and improve clinical outcomes

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Presented at American Society of Neuroradiology (ASNR) Annual Meeting, May 16-18, 2022, New York City, NY.

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