Is the "snake-eye" MRI Sign Correlated to Anterior Spinal Artery Occlusion on CT Angiography in Cervical Spondylotic Myelopathy and Amyotrophy?

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2014 May 15

PMID 24823850

Citations 12

Authors

Zhengfeng Zhang

Honggang Wang

Affiliations

Soon will be listed here.

Abstract

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.

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References

Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K . Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976). 1981; 6(4):354-64. DOI: 10.1097/00007632-198107000-00005. View

Ebara S, Yonenobu K, Fujiwara K, Yamashita K, Ono K . Myelopathy hand characterized by muscle wasting. A different type of myelopathy hand in patients with cervical spondylosis. Spine (Phila Pa 1976). 1988; 13(7):785-91. DOI: 10.1097/00007632-198807000-00013. View

Zhang Z, Wang H . CT angiography of anterior spinal artery in cervical spondylotic myelopathy. Eur Spine J. 2013; 22(11):2515-9. PMC: 3886512. DOI: 10.1007/s00586-013-2874-6. View

Kieffer E, Fukui S, Chiras J, Koskas F, Bahnini A, Cormier E . Spinal cord arteriography: a safe adjunct before descending thoracic or thoracoabdominal aortic aneurysmectomy. J Vasc Surg. 2002; 35(2):262-8. DOI: 10.1067/mva.2002.120378. View

KEEGAN J . The cause of dissociated motor loss in the upper extremity with cervical spondylosis. J Neurosurg. 1965; 23(5):528-36. DOI: 10.3171/jns.1965.23.5.0528. View

Takahashi M, Yamashita Y, Sakamoto Y, Kojima R . Chronic cervical cord compression: clinical significance of increased signal intensity on MR images. Radiology. 1989; 173(1):219-24. DOI: 10.1148/radiology.173.1.2781011. View

Ou P, Schmit P, Layouss W, Sidi D, Bonnet D, Brunelle F . CT angiography of the artery of Adamkiewicz with 64-section technology: first experience in children. AJNR Am J Neuroradiol. 2007; 28(2):216-9. PMC: 7977420. View

Zhang Z, Wang H, Zhou Y, Wang J . Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury. Spinal Cord. 2013; 51(6):442-7. DOI: 10.1038/sc.2012.179. View

Gilles F, Nag D . Vulnerability of human spinal cord in transient cardiac arrest. Neurology. 1971; 21(8):833-9. DOI: 10.1212/wnl.21.8.833. View

10.

Herrick M, Mills Jr P . Infarction of spinal cord. Two cases of selective gray matter involvement secondary to asymptomatic aortic disease. Arch Neurol. 1971; 24(3):228-41. DOI: 10.1001/archneur.1971.00480330056005. View

11.

Nijenhuis R, Leiner T, Cornips E, Wilmink J, Jacobs M, van Engelshoven J . Spinal cord feeding arteries at MR angiography for thoracoscopic spinal surgery: feasibility study and implications for surgical approach. Radiology. 2004; 233(2):541-7. DOI: 10.1148/radiol.2331031672. View

12.

Oshima Y, Seichi A, Takeshita K, Chikuda H, Ono T, Baba S . Natural course and prognostic factors in patients with mild cervical spondylotic myelopathy with increased signal intensity on T2-weighted magnetic resonance imaging. Spine (Phila Pa 1976). 2012; 37(22):1909-13. DOI: 10.1097/BRS.0b013e318259a65b. View

13.

Zhao S, Logan L, Schraedley P, Rubin G . Assessment of the anterior spinal artery and the artery of Adamkiewicz using multi-detector CT angiography. Chin Med J (Engl). 2009; 122(2):145-9. View

14.

Shibuya R, Yonenobu K, Yamamoto K, Kuratsu S, Kanazawa M, Onoue K . Acute arm paresis with cervical spondylosis: three case reports. Surg Neurol. 2005; 63(3):220-8. DOI: 10.1016/j.surneu.2004.04.023. View

15.

Uchida K, Nakajima H, Takeura N, Yayama T, Guerrero A, Yoshida A . Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy. Spine J. 2014; 14(8):1601-10. DOI: 10.1016/j.spinee.2013.09.038. View

16.

Baron E, Young W . Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis. Neurosurgery. 2007; 60(1 Supp1 1):S35-41. DOI: 10.1227/01.NEU.0000215383.64386.82. View

17.

Than K, Sangala J, Wang A, Gandhi D, La Marca F, Park P . The current status and recent advances in high-resolution imaging of spinal vascular malformations. J Clin Neurosci. 2012; 20(1):66-71. DOI: 10.1016/j.jocn.2012.05.008. View

18.

KRAUSS W . Vascular anatomy of the spinal cord. Neurosurg Clin N Am. 1998; 10(1):9-15. View

19.

Vedantam A, Rajshekhar V . Does the type of T2-weighted hyperintensity influence surgical outcome in patients with cervical spondylotic myelopathy? A review. Eur Spine J. 2012; 22(1):96-106. PMC: 3540309. DOI: 10.1007/s00586-012-2483-9. View

20.

Tsuboi Y, Tokumaru Y, Hirayama K . [Clinical difference between "proximal" and "distal" type of cervical spondylotic amyotrophy]. Rinsho Shinkeigaku. 1995; 35(2):147-52. View