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DWI in cervical spine herniation

Case Study
Casselman, Jan, M.D., Ph.D. Brugge, AZ St. Jan AV Belgium

DWI of the cervical spine on Achieva 3.0T X-series

Patient history:

A patient presented with cervical herniation causing medulla compression. The patient was examined on Achieva 3.0T X-series at General Hospital St. Jan, Brugge, Belgium.

MR examination:

High resolution diffusion-weighted imaging DWI (1.4 x 1.4 x 3 mm in 2.06 minutes) was performed in the cervical spine. DWI images at the level of the herniation and medulla compression were compared to DWI at a normal level.

 

The SENSE NeuroVascular 16 coil was used.

b 0 normal level A low signal intensity medulla surrounded by CFS can be seen.b 1000 normal level A normal low intensity medulla is seen, while the CSF is no longer visible.
b 0 normal level
b 1000 normal level
A low signal intensity medulla surrounded by CFS can be seen.
A normal low intensity medulla is seen, while the CSF is no longer visible.
b 0 at the level of compression The medulla has a higher signal than at the normal level in the image above. High signal CSF can only be seen lateral to the medulla.b 1000 at level of compression Signal within the medulla is high compared to the normal level in the image above, indicating diffussion restriction and acute changes.Axial FFE at level of compression Compressed medulla (arrowhead) and the compressing hernia (arrows) can be seen.
b 0 at the level of compression
b 1000 at level of compression
Axial FFE at level of compression
The medulla has a higher signal than at the normal level in the image above. High signal CSF can only be seen lateral to the medulla.
Signal within the medulla is high compared to the normal level in the image above, indicating diffussion restriction and acute changes.
Compressed medulla (arrowhead) and the compressing hernia (arrows) can be seen.

Diagnosis:

At the level of compression, the examination indicated, diffusion restriction and acute changes requiring urgent decompression.

Clinical impact of SENSE NeuroVascular 16 coil:

The SENSE NeuroVascular 16 coil enables good quality, high resolution DWI of the cervical medulla without any artifacts. The DWI results can help to evaluate acute infarction and distinguish recent as well as old changes due to medulla compression.

Related information:



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Sep 4, 2008

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Case Study
Achieva 3.0T X-series
Release 2, Release 2.5
Quasar, Quasar Dual
3T, Cervical spine, Neuro
 

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