Treatment Outcome and Prognosis Regarding to MR Pattern and Signal Area in Spinal Cord Injury / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: To determine the capability to predict the clinical manifestations and treatment outcomes of traumatic cervicothoracic cord injury patients based on MR images. OBJECTIVE: To determine the relationship between the differences in MR patterns and signal areas according to Maravilla and Cohen's classification and the PACS system compared with the Frankel classification, in patients that demonstrated neurologic improvement within 1 year. SUMMARY OF LITERATURE REVIEW MR is the first imaging modality that directly visualizes the extent of spinal cord derangement, and thus, it has the potential to provide an accurate diagnosis of an injury and to determine the prognosis. MATERIALS AND METHODS: MR images were evaluated within 3 days of trauma in 36 spinal cord injury patients. The clinical follow-up period was more than 1 year. Quantitative analysis of spinal cord lesions was performed according to the PACS system. RESULTS: According to Maravilla and Cohen's classification, 36 cases were classified as follows 8 cases of type I, 10 cases of type II, 9 cases of type III and 9 cases of type IV. There was 1 case of type I, 8 cases of type II, 5 cases of type III, and no cases of type IV, who demonstrated neurologic improvements of more than 1 grade in the Frankel classification. An analysis of the signal areas according to the PACS system demonstrated no cases of areas greater than 100 mm2, 5 cases of areas between 50 to 100 mm2, and 9 cases of areas less than 50 mm2 who demonstrated neurologic improvement. CONCLUSION: Classification according to the differences between MR imaging and MRI signal areas in patients with spinal cord injuries demonstrated the indicators of neurologic improvement; therefore, we MR imaging can be utilized as a prognostic factor in cases of spinal cord injuries.