ROLE OF MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF SPINAL CORD LESIONS IN A TERTIARY CARE HOSPITAL, HYDERABAD

Abstract

Objective: Using other imaging modalities, subtle bone marrow, soft tissue, and spinal cord abnormalities, which may not be apparent, can be readily detected on magnetic resonance imaging (MRI). Prompt and accurate diagnosis, expeditious management, and avoidance of unnecessary procedures are achieved by early detection.

The aim is to study the role of MRI in diagnosing spinal cord lesions.

Methods: This study was conducted during the period from November 2018 to November 2020 and it is a prospective descriptive study of 50 patients who were referred to the Department of Radiodiagnosis Osmania General Hospital and MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana.

Results: In the present study of 50 cases, different spinal cord lesions were found. The most common spinal cord lesions were neoplastic (38%) followed by spinal cord trauma (28%), and congenital lesions (16%). The most common spinal lesions were found in the 20–29 age group (40%), with more male predilection of 72% in comparison to 28% female in the present study. Out of 19 neoplastic lesions, the most common type of intramedullary spinal cord tumor (IMSC) is ependymoma (31.5%). The second most common IMSC tumor is astrocytoma 15.7% of all neoplastic lesions in the present study and the most common tumor among children. The most common location of the lesion is the thoracic cord. Hemangioblastomas constitute 10.5% of all spinal cord tumors in the present study. Meningiomas which are intradural extramedullary lesions constituted 10.5%. Neurofibroma constituted 5.2% which are intradural extramedullary with extradural component noted in NF1. Spinal cord metastasis constituted 26.3%. Intradural intramedullary lesions constituted 48% followed by extradural lesions 40% followed by intradural extramedullary lesions 12%.

Conclusion: MRI by virtue of non-invasiveness, lack of radiation hazard, and the ability to demonstrate structural changes is an investigation of choice for spinal cord pathologies. The ability to image the cord directly rather than indirectly as in myelography, the absence of bone artifacts as in computed tomography, and the multiplanar capabilities indicate that MRI is the procedure of choice in the examination of the spinal cord.