Imaging

Spinal Cord Infarction

Preliminary Diagnosis: Spinal cord infarction

I. What imaging technique is first-line for this diagnosis

  • Contrasted intradural protocol MR of the spine with diffusion-weighted sequences.

II. Describe the advantages and disadvantages of this technique for diagnosis of spinal cord infarction.

Advantages

  • Highly specific and sensitive for any subtle signal abnormality within the spinal cord that may represent edema in the setting of infection, inflammation, ischemia, infarction, or trauma that is not appreciated on CT imaging or any of the imaging modalities.

  • Able to detail any secondary abnormalities causing spinal cord infarct such as an underlying mass or vascular malformation.

Disadvantages

  • Does not provide great detail of the osseous structures.

  • Expensive

  • Time-consuming

  • Requires significant patient cooperation to minimize motion artifact

III. What are the contraindications for the first-line imaging technique?

  • Contraindicated in patients with non-MR compatible hardware.

  • Gadolinium contrast is contraindicated in patients with a GFR less than or equal to 30.

IV. What alternative imaging techniques are available?

  • No specific alternative imaging techniques exist.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of spinal cord infarction.

  • Not applicable.

VI. What are the contraindications for the alternative imaging techniques?

  • Not applicable.

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