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The Role of Diffusion-Weighted MRI in Differentiation of Idiopathic Acute Transverse Myelitis and Acute Spinal Cord Infarction  

Kim, Yeo-Goon (Department of Radiology, Seoul National University Bundang Hospital)
Lee, Joon-Woo (Department of Radiology, Seoul National University Bundang Hospital)
Kim, Jae-Hyoung (Department of Radiology, Seoul National University Bundang Hospital)
Kang, Heung-Sik (Department of Radiology, Seoul National University Bundang Hospital)
Park, Kyung-Seok (Department of Neurology, Seoul National University Bundang Hospital)
Publication Information
Journal of the Korean Society of Radiology / v.65, no.2, 2011 , pp. 101-108 More about this Journal
Abstract
Purpose: To compare the diffusion characteristics of idiopathic acute transverse myelitis (ATM) and acute spinal cord infarction (SCI). Materials and Methods: Diffusion-weighted images (DWI) and an apparent diffusion coefficient (ADC) map were prospectively obtained from patients diagnosed with myelopathy between February 2006 and April 2009. Inclusion criteria included 1) the presence of an intramedullary T2-high signal intensity and 2) a final diagnosis of idiopathic ATM or SCI established by one neurologist. In total, 13 patients (M : F = 8 : 5; mean age, 39.5 years; range, 29-50 years) with idiopathic ATM and seven patients (M : F = 2 : 5; mean age, 58 years; range, 48-75 years) with SCI were included in this study. Two radiologists evaluated the DWIs and ADC map in consensus. The extent of the cord signal change was also evaluated on T2-weighted sagittal images. Results: Among the 16 patients with ATM, 14 patients showed iso-signal on an ADC map, but one case showed restricted diffusion and another showed increased diffusion on the ADC map. Among the seven patients with SCI, five patients showed restricted diffusion. Conclusion: Idiopathic ATM usually does not demonstrate restricted diffusion, which can be a clue to differentiate it from SCI. However, idiopathic ATM with larger segment involvement can show focal diffusion restriction.
Keywords
Diffusion Weighted Image; Acute Transverse Myelitis; Acute Spinal Cord Infarction;
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