MRI evaluation of sequential changes of the injured spinal cord

Thirty-seven cases of acute spinal cord injury were studied with MRI and correlated with the neurological findings. Nineteen out of 37 cases were followed by sequential MRI for 10 days to 1 year. Cord abnormalities, including cord compression, cord swelling, and abnormal signal intensities were observed on the initial MR images, followed by various changes, depending on the nature of the initial damage on the subsequent MR images. The most frequent initial changes within the cord included isointensity on both T1- and T2-weighted images or isoin-tensity on T1-weighted images and hyperintensity on T2-weighted images, followed at 2 months by persistence of isointensity on T1-weighted images and hyperintensity on T2-weighted images. The most common final MR appearance was hypointensity on T1-weighted images and hyperintensity on T2-weighted images. The size of the hyperintense area on T2-weighted images was the most important finding in predicting the prognosis of spinal cord injuries.