Posttraumatic syringomyelia: volumetric phantom and patient studies using MR imaging

The purpose of this study was to determine the volume of posttraumatic syringomyelia (PTS) based on standard MRI data acquisitions, and to compare the volumes with the neurological deficits of the patients. Firstly, phantom studies were performed using routine T1- (T1W; TR 500 ms, TE 13 ms) spin-echo (SE) images, 3D gradient-echo (GE) images and T2-weighted (T2W) turbo spin-echo (TSE) images (TR 3000 ms, TE 130 ms), in the sagittal plane. The slices were interleaved so that there was no gap. Twelve phantoms simulating a PTS were constructed and filled with fluid. Each volume was exactly measured immediately prior to filling (volumes: 3600–74,000 mm³, mean 27,500 mm³). In the clinical study 32 patients with PTS were examined using the same protocol. Patients were supine and a phased-array coil was used. The phantom studies revealed measurement errors of within 35%. There were problems defining the boundaries in the small and irregular phantoms as well as in small and irregular PTS, and due to the partial-volume averaging effect. The two small irregular phantoms could only be measured on the axial images. The T2W images in the axial plane showed the best results: measurement accuracy 92%. In the clinical study all examinations were technically successful. The volumes of the PTS ranged between 200 and 19,800 mm³; the mean volume was 4075 mm³. Our initial results show that the volume measurement of a PTS using standard MRI sequences can help generate more objective and accurate measures of spinal cord lesions, and this may enhance the sensitivity of MRI in detecting disease progression or regression after treatment. Electronic Publication