MRI appearance of acute spinal cord injury with short term follow up.

Dungan, D., Radiology Imaging Associates, Englewood, Colorado

Purpose: To determine short term changes in imaging characteristics of acute spinal cord injury.

Material and Methods: As part of the ProCord spinal cord injury trial, spinal MRI examinations were performed within 4 days of complete spinal cord injury using routine MRI sequences. Short term follow up exams were performed within 12 days of injury. Cranio-caudal extent of cord edema and contusion were measured by fellowship trained neuroradiologists.

Results: Initial MRI exams were performed an average of 1.0 days post injury. On initial MRI exams, cord contusion measured between 9 to 29 mm in length, with an average of 19 mm and standard deviation of 6.6 mm. Follow up exams were performed an average of 10 days post injury, and showed length of contusion ranging from 11 to 52 mm. Contusion length averaged 24 mm, with standard deviation of 10mm. Change in lesion length during this short term was between -15 mm (decrease in apparent length of contusion) and 39mm (increase in length of contusion).

Conclusion: Extent of spinal cord injury as detected by MRI changes in the first two weeks following traumatic spinal cord injury, with both increase and decrease in apparent contusion length possible. This may have implications for treatment methodologies in acute spinal cord injury.