The Importance of Flexion MRI in Hirayama Disease with Special Reference to Laminodural Space Measurements
| Autor: | Rajanikant R Yadav, B. Sarma, Deb K Boruah, Arjun Prakash, B.B. Gogoi, Dhabal D Dhingani |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Brachioradialis Spinal Muscular Atrophies of Childhood 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences 0302 clinical medicine Anterior Horn Cell medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Epidural venous plexus business.industry Cervical Cord Amyotrophy medicine.disease Magnetic Resonance Imaging Spine Hyperintensity Cross-Sectional Studies medicine.anatomical_structure Cervical Vertebrae Upper limb Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery Cervical vertebrae |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a5577 |
| Popis: | BACKGROUND AND PURPOSE: Hirayama disease is a benign focal amyotrophy of the distal upper limbs involving C7, C8, and T1 segmental myotomes with sparing of the brachioradialis and proximal muscles of the upper limb innervated by C5–6 myotomes. The objective of the present study was to study the utility of MR imaging in young patients presenting with weakness and wasting of the distal upper extremity and to evaluate the importance of the laminodural space during flexion cervical MR imaging. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted from January 2014 to July 2017 in a tertiary care center from Northeast India. Forty-five patients with clinically definite Hirayama disease underwent electrophysiologic evaluation followed by MR imaging of the cervical spine. RESULTS: The mean age at recruitment was 22.8 ± 5.5 years. Forty patients (88.9%) had unilateral and 5 (11.1%) had bilateral upper extremity involvement. Cervical cord T2-weighted hyperintensities were demonstrated in 16 patients (35.6%), of which 15 (33.3%) had anterior horn cell hyperintensities. Flexion MR imaging showed loss of the posterior dural attachment, forward shifting of the posterior dural sac with postcontrast enhancement, and prominent posterior epidural venous plexus in all patients. The laminodural space at maximum forward shifting of the posterior dural sac ranged from 3 to 9.8 mm, with a mean distance of 5.99 mm (95% confidence interval, 5.42–6.57 mm). CONCLUSIONS: Flexion cervical MR imaging is a very useful investigation in diagnosing Hirayama disease. The increase in the laminodural space and the presence of cervical cord flattening during flexion are essential for diagnosis. |
| Databáze: | OpenAIRE |
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