Article

MR imaging of spinal nerve roots: techniques, enhancement patterns, and imaging findings.

Department of Radiology, University of South Alabama, Mobile 36617, USA.
American Journal of Roentgenology (Impact Factor: 2.74). 02/1996; 166(1):173-9. DOI: 10.2214/ajr.166.1.8571871
Source: PubMed

ABSTRACT The purpose of this report was to review the MR techniques, contrast enhancement patterns, and MR imaging findings for the spinal nerve roots. The phenomenon of contrast enhancement of the nerve roots and its relationship to disk disease and failed-back-surgery syndrome are discussed. The MR imaging findings for various inflammatory and neoplastic disorders affecting the spinal nerve roots are described and illustrated.

1 Follower
 · 
236 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Enterovirus D68 was responsible for widespread outbreaks of respiratory illness throughout the United States in August and September 2014. During this time, several patients presented to our institution with acute flaccid paralysis and cranial nerve dysfunction. The purpose of this report is to describe the unique imaging findings of this neurologic syndrome occurring during an enterovirus D68 outbreak. Patients meeting a specific case definition of acute flaccid paralysis and/or cranial nerve dysfunction and presenting to our institution during the study period were included. All patients underwent routine MR imaging of the brain and/or spinal cord, including multiplanar T1, T2, and contrast-enhanced T1-weighted imaging. Eleven patients met the inclusion criteria and underwent MR imaging of the brain and/or spinal cord. Nine patients presented with brain stem lesions, most commonly involving the pontine tegmentum, with bilateral facial nerve enhancement in 1 patient. Ten patients had longitudinally extensive spinal cord lesions; those imaged acutely demonstrated involvement of the entire central gray matter, and those imaged subacutely showed lesions restricted to the anterior horn cells. Ventral cauda equina nerve roots enhanced in 4 patients, and ventral cervical nerve roots enhanced in 3, both only in the subacute setting. Patients presenting with acute flaccid paralysis and/or cranial nerve dysfunction during the recent enterovirus D68 outbreak demonstrate unique imaging findings characterized by brain stem and gray matter spinal cord lesions, similar to the neuroimaging findings described in previous outbreaks of viral myelitis such as enterovirus 71 and poliomyelitis. © 2015 American Society of Neuroradiology.
    American Journal of Neuroradiology 11/2014; 36(2). DOI:10.3174/ajnr.A4188 · 3.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Focal spinal cord displacement can be caused by idiopathic spinal cord herniation (ISCH), in which the cord protrudes through a dural defect into the epidural space, causing cord displacement and tethering. ISCH is uncommon and often is misdiagnosed initially, which results in delayed management. ISCH can be mimicked by space-occupying cerebrospinal fluid (CSF)-isointense intraspinal extramedullary lesions, such as epidermoid cysts or teratomas, intradural arachnoid cysts, epidural hematomas or abscesses, cystic nerve sheath tumors, synovial or Tarlov cysts, meningoceles, and pseudomeningoceles. Initial computed tomography (CT) and unenhanced magnetic resonance (MR) imaging studies may depict focal cord displacement and a widened CSF space but often are not sufficient to identify the underlying cause. High-resolution thin-section MR imaging can delineate the exact location of the dural defect and the protrusion of the herniated cord through this defect into the epidural space. At imaging, unimpeded CSF pulsation artifacts seen within a widened CSF space exclude a space-occupying lesion. A filling defect seen at conventional or CT myelography can help confirm a CSF-isointense space-occupying lesion; intravenous contrast agent administration can help exclude a rim-enhancing cystic extramedullary lesion. The clinical presentation usually is nonspecific, but symptom acuity, fever, and trauma can guide the imaging evaluation and help narrow the differential diagnosis. A multimodality imaging approach is essential to differentiate ISCH from space-occupying CSF-isointense intraspinal extramedullary lesions. © RSNA, 2014.
    Radiographics 03/2014; 34(2):313-29. DOI:10.1148/rg.342125136 · 2.73 Impact Factor
  • Journal of NeuroVirology 04/2013; 19(3). DOI:10.1007/s13365-013-0163-0 · 3.32 Impact Factor

Preview

Download
4 Downloads
Available from