MR-IMAGING IN THE DIAGNOSIS OF INTRAMEDULLARY SPINAL-CORD DISEASES THAT INVOLVE SPECIFIC NEURAL PATHWAYS OR VASCULAR TERRITORIES

Prior to the advent of MR imaging, the internal architecture of the sp inal cord could not be directly imaged. The solution of many technical problems (e.g., respiratory motion, cardiac and CSF pulsation, inadeq uate spatial resolution) has provided the opportunity for an increasin gly refined analysis of intramedullary lesions. This article begins wi th a brief review of the results of high-resolution MR imaging studies of the cadaveric spinal cord. The article then focuses on MR imaging in the diagnosis of intramedullary diseases that involve specific neur al pathways or vascular territories, Lesions are categorized as degene rative, inflammatory, traumatic, or ischemic, These diseases generally have distinctive clinical findings that reflect dysfunction of partic ular ascending sensory tracts or descending motor tracts, The correspo nding abnormalities on MR images reflect the pathologic changes that o ccur in the affected neural pathways, Knowledge of the appearance of t hese diseases on MR images allows the formation of a narrow differenti al diagnosis and, in many cases, the confident exclusion of neoplasm a s the cause of myelopathy.