Location, length, and enhancement: systematic approach to differentiating intramedullary spinal cord lesions

This article will provide a systematic approach to the evaluation of intramedullary spinal cord lesions —with emphasis on location, length and segment distribution, and enhancement pattern—to help narrow the differential diagnosis. In doing so, we will review various spinal cord pathologies, including demyelinating and metabolic conditions, neoplasms, and vascular lesions.Summary/conclusionAlthough intramedullary spinal cord abnormalities can be a challenge for the radiologist, a systematic approach to the differential diagnosis with a focus on lesion location, cord length and segment involvement, as well as enhancement pattern, can greatly help narrow the differential diagnosis, if not synch the diagnosis. This strategy will potentially obviate the need for an invasive approach to diagnosis and help guide treatment.Teaching points•Imaging diagnosis of intramedullary spinal cord lesions could obviate cord biopsy.•Evaluation of cord lesions should focus on location, length, and enhancement pattern.•In demyelination, the degree of cross-sectional involvement is a distinguishing feature.
Source: Insights into Imaging - Category: Radiology Source Type: research