Monitoring the evolution of intramedullary lesions in cervical spinal cord injury. Qualitative and quantitative analysis with sequential MR imaging.

The evolution of intramedullary lesions following an acute spinal cord injury was monitored with sequential magnetic resonance (MR) imaging. Seven patients who had sustained cervical spinal cord injuries were followed up from the acute to the chronic phase of the cord injury. MR images were evaluated not only qualitatively but also quantitatively. All intramedullary lesions were quantitatively analysed by T2 values. In the qualitative analysis, the regions with hyperintensity on T2-weighted images and isointensity on T1-weighted images were consistent with the region of simple oedema or gliosis. The former gradually disappeared after the acute phase, whereas the latter remained until the chronic phase. The regions with hyperintensity on T2-weighted images and hypointensity on T1-weighted images may represent cysts filled with necrotic tissue or clear fluid, or necrosis. The evolution of these lesions was also able to be monitored quantitatively by T2 values.