The value of diffusion magnetic resonance imaging in diagnosing infarction of the anterior spinal artery
Dinca-Avarvarei, L.; Valdés-Cruces, J.C.; Quesada-García, M.; Izquierdo, G.
Revista de Neurologia 40(5): 282-285
2005
ISSN/ISBN: 0210-0010 PMID: 15782359 Document Number: 592896
The diagnosis of ischemic lesions affecting the spinal cord is sometimes difficult to confirm using conventional magnetic resonance imaging (MRI) techniques, and this makes it necessary to use those currently available to their full extent and also to search for new ones. We report the case of an 81-year-old male patient who presented symptoms of sudden onset paraparesis, secondary to lesions in the anterior spinal territory and whose diagnosis was reached using conventional spinal cord MRI, and later confirmed with the diffusion imaging technique. Diffusion MRI in the spinal cord territory, as well as in the brain territory, is a very interesting first choice technique when an ischemic pathology is suspected. Using only T2-weighted images does not allow acute ischemic lesions to be distinguished from chronic lesions; likewise, intramedullary T2 hyperintensity and standard DWI (Diffusion Weighted Imaging) is not specific to acute spinal ischemia, and the determination of the apparent diffusion coefficient in the lesion may help in the differential diagnosis of diseases affecting the spinal cord. Including diffusion RMI techniques in the study protocols in cases of ischemic spinal cord pathologies is indispensable today if we hope to reach a fast and correct diagnosis.