MR imaging in radiation myelopathy

• Published in: American journal of neuroradiology : AJNR 1992-07, Vol.13 (4), p.1049-1055
• Main Authors: Wang, PY, Shen, WC, Jan, JS
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nasopharyngeal Neoplasms - radiotherapy; Radiotherapy - adverse effects; Spinal Cord Diseases - diagnosis; Spinal Cord Diseases - etiology
• ISSN: 0195-6108; 1936-959X

Using MR imaging, we assessed the signal, size, and enhancing characteristics of the cervical cord in patients in whom radiation myelopathy developed after radiotherapy for nasopharyngeal carcinoma. Ten patients, 3 men and 7 women, aged from 32 to 77 years, were included. MR imaging was performed 1 to 53 months after clinical manifestations of myelopathy. Two cases showed atrophy of the cervical cord without abnormal signal intensity; in the others, a long segment of the cervical cord demonstrated low signal intensity on T1-weighted images and high signal intensity on T2- or T2*-weighted images. Some of these cases also showed swelling of the cord. Focal enhancement at C1-C2 area after intravenous administration of Gd-DTPA was seen in four cases. There is a correlation between the time of MR imaging after onset of symptoms and MR findings. When MR scans were obtained more than 3 years after onset of symptoms, atrophy of the cervical cord was noted without abnormal signal intensity. When MR was performed less than 8 months after onset of symptoms, a long segment of the cervical cord demonstrated abnormal signal intensity with or without associated swelling of the cord and focal enhancement.