Anatomy-Based Imaging Issues Neoplasms affecting the spine may spread by direct extension via the lymphatic system, the hematogenous route, or along the cerebrospinal fluid (CSF) pathways. There can also be combinations of these pathways involved, with the most typical being…
KEY FACTS Terminology Paraneoplastic neurologic disorder Antineuronal immune mechanism targeting CNS, occurring in conjunction with cancer Imaging Longitudinally extensive, symmetric, tract-specific signal changes within spinal cord that often enhance after gadolinium administration in patient with cancer Signal abnormality in ~…
KEY FACTS Terminology Vitamin B12 deficiency produces selective degeneration of dorsal ± lateral spinal cord columns Imaging Longitudinal dorsal cord T2 signal abnormality Axial image → “inverted V” or “inverted rabbit ears” within dorsal spinal cord ± mild dorsal column…
KEY FACTS Terminology Neurosarcoidosis Noncaseating granulomatous disease of spine and spinal cord Imaging Combination of leptomeningeal and peripheral intramedullary mass-like enhancement suggestive of spinal sarcoidosis Intramedullary Fusiform cord enlargement Enhancing intramedullary masses Focal or diffuse T2-hyperintense lesions Intradural extramedullary Leptomeningeal…
KEY FACTS Terminology Clinically heterogeneous, grossly symmetric, sensory and motor neuropathy evolving as monophasic, relapsing, or progressive disorder Develops over > 8 weeks Imaging Enlargement and abnormal T2 hyperintensity of nerve roots, plexi, or peripheral nerves Spinal nerve roots and…
KEY FACTS Terminology Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) a.k.a. Guillain-Barré syndrome (GBS) Autoimmune postinfectious or postvaccinial acute inflammatory demyelination of peripheral nerves, nerve roots, cranial nerves Imaging Smooth pial enhancement of cauda equina and conus medullaris Nerve roots often slightly…
KEY FACTS Terminology Para-/postinfectious immune-mediated inflammatory disorder of white matter (WM) Antibodies to pathogens exhibit cross-immunoreactivity with myelin basic protein Imaging Multifocal short-segment WM lesions with relatively little mass effect or vasogenic edema Flame-shaped lesions with slight cord swelling Dorsal…
KEY FACTS Terminology Neuromyelitis optica (NMO) NMO spectrum disorders Idiopathic inflammatory demyelinating disorder of CNS characterized by severe attacks of optic neuritis and myelitis Imaging Hyperintense, mildly enlarged optic nerves Expansile, hyperintense cord signal, ≥ 3 segments Long segment optic…
KEY FACTS Terminology Primary demyelinating disease of central nervous system with multiple lesions disseminated over time and space Concomitant intracranial lesions in periventricular, subcallosal, brain stem, or cerebellar white matter Imaging Isolated spinal cord disease (10-20%) Cervical segment is most…
KEY FACTS Terminology Inflammatory disorder involving both halves of spinal cord, resulting in bilateral motor, sensory, and autonomic dysfunction Imaging Central cord expansile lesion > 2 vertebral segments in length ± variable eccentric enhancement Top Differential Diagnoses Multiple sclerosis Neuromyelitis…