MR Spectroscopy of Cervical Spinal Cord in Patients with Clinical and/or Electrophysiologic Signs of Spinal Cord Compression

Abstract

We evaluated the efficiency of MR spectroscopy compared with conventional MR imaging in 14 patients with clinical and/or electrophysiologic signs of spinal cord compression. Cervical spinal cord was evaluated for the presence of abnormal signal intensity on T1 and T2 weighted images. MR spectroscopy was performed at the level of spinal cord compression seen on conventional MR images. Clinical and/or electrophysiological studies were also obtained to confirm the presence of a suspected spinal cord compression for these areas. MR spectroscopy was also performed at a normal site of spinal cord without any clinical and/or electrophysiological finding of compression and without any sign of compression on conventional MR images. MR spectroscopy findings of suspected areas were compared with the normal areas for each patient. Twenty levels of cervical spinal cord with both clinical and/or electrophysiological and conventional MR signs of compression were evaluated with MR spectroscopy. MR spectroscopy was also performed at the normal areas of the cervical spinal cord selected adjacent to the level of compression as vascularity and metabolism of cervical spinal cord significantly change between different levels. All patients except one had a decrease in N-acetylaspartate level at the suspected areas compared to the normal areas without any sign or suspicion of compression. Creatine levels were increased in 14 suspected area but decreased in six. Choline levels were decreased in 12 and increased in eight levels. Lactate levels were increased at eight levels and decreased in 12 levels. MR spectroscopy of the spinal cord can yield results supporting both clinical and electrophysiological evaluation. MR spectroscopy of the spinal cord at the level of compression observed on conventional MR images can support neuronal loss and disruption of axonal integrity.