The current status and recent advances in high-resolution imaging of spinal vascular malformations

Spinal vascular lesions: anatomy, imaging techniques and treatment

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Vascular myelopathies include different aetiology and mechanism of damage.

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The level of the lesion and the localization within the SC correlates with the clinical symptoms.

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CT, MRI and angiography are essential for diagnosis and treatment playing a complementary role.

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MRI is the gold standard for the evaluation of spinal cord lesions.

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Spinal angiography is the gold standard for evaluation of spinal cord vasculature and vascular malformations.

Background

Vascular lesions of the spinal cord are rare but potentially devastating conditions whose accurate recognition critically determines the clinical outcome. Several conditions lead to myelopathy due to either arterial ischemia, venous congestion or bleeding within the cord. The clinical presentation varies, according with the different aetiology and mechanism of damage.

Purpose

The aim is to provide a comprehensive review on the radiological features of the most common vascular myelopathies, passing through the knowledge of the vascular spinal anatomy and the clinical aspects of the different aetiologies, which is crucial to promptly address the diagnosis and the radiological assessment.

Is the "snake-eye" MRI sign correlated to anterior spinal artery occlusion on CT angiography in cervical spondylotic myelopathy and amyotrophy?

OBJECTIVE

The goal of this study was to identify anterior spinal artery (ASA) occlusion by CT angiography in cervical spondylotic myelopathy (CSM) and amyotrophy (CSA) with T2-weighted hyperintensity of MR image of documented small intramedullary high signal intensity known as "snake-eye appearance" (SEA).

METHOD

One hundred and six patients with CSM were admitted to the investigator group between June 2010 and June 2013. Intramedullary high signal intensity was found in 42 cases and was divided into two types, SEA and non-SEA. SEA was observed in 10 patients, including seven CSM patients and three CSA patients. All SEA patients were performed CT angiography of ASA after admission.

RESULTS

The ASA was visualized in all 10 patients. ASA incomplete occlusion was found in one CSA patient and one CSM patient. No ASA occlusion was found in other CSA and CSM patients with SEA.

CONCLUSION

ASA occlusion is not commonly seen in CSM and CSA patients with SEA. Pathological changes about SEA in CSM and CSA have no close correlation with ASA occlusion, but may be with anterior radiculomedullary arteries.