RADIATION MYELOPATHY - A CLINICOPATHOLOGICAL STUDY WITH SPECIAL REFERENCE TO CORRELATION BETWEEN MRI FINDINGS AND NEUROPATHOLOGY

We describe magnetic resonance imaging (MRI) and neuropathological fin dings in a patient with chronic progressive radiation myelopathy (CPRM ). hn 81-year-old man with esophageal cancer underwent radiotherapy. F our years later he developed a progressive neurological deficit below the irradiated level of the spinal cord. Neurological examination reve aled spastic paraplegia. MRI findings showed an area of high signal in tensity on T2-weighted images of the thoracic spinal cord. On the basi s of clinical and MRI findings, we diagnosed his condition as CPRM. MR I performed thirteen months after onset of neurological signs revealed mild atrophy of the spinal cord detected on T1-weighted images and an area of high signal intensity within the spinal cord detected on T2-w eighted images. Neuropathological examination revealed findings consis tent with radiation myelopathy. We speculate that the area of high sig nal intensity within the spinal cord detected on T2-weighted images mi ght be a result of proliferation of small vessels, which was discovere d upon autopsy.