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Research ArticleSpine

MRI T2-Hyperintense Signal Structures in the Cervical Spinal Cord: Anterior Median Fissure versus Central Canal in Chiari and Control—An Exploratory Pilot Analysis

T.A. Tomsick, L.L. Wang, M. Zuccarello and A.J. Ringer
American Journal of Neuroradiology April 2021, 42 (4) 801-806; DOI: https://doi.org/10.3174/ajnr.A7046
T.A. Tomsick
aFrom the Department of Radiology (T.A.T., L.L.W.)
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L.L. Wang
aFrom the Department of Radiology (T.A.T., L.L.W.)
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M. Zuccarello
bNeuroradiology Section and Department of Neurosurgery (M.Z.), University of Cincinnati Medical Center, Cincinnati, Ohio
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A.J. Ringer
cMayfield Clinic (A.J.R.), Cincinnati, Ohio
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Article Figures & Data

Figures

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  • FIG 1.
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    FIG 1.

    A patient with Chiari I with 19 HIF up to 3 mm in diameter, 1 AMF, no AMF>HIF, and an SL of various hyperintensity and diameter from C4 through T1, consistent with hydromyelia.

  • FIG 2.
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    FIG 2.

    Postdecompressive craniectomy patient with Chiari I with 9 HIF, 4 AMFs, 1 AMF>HIF, and sharp and hyperintense SLs at C6–C7 and less hyperintense, sharp, and defined SLs at C2–C6.

  • FIG 3.
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    FIG 3.

    Control patient with 15 HIF, 3 AMFs, 3 AMF>HIF, and SL with variably hyperintense and variably sharp dots and dashes from C3–4 to C7. Note hyperintense pixels immediately anterior to the AMF on axial images, despite crescentic flow-related signal loss immediately anterior to the cord on most images.

  • FIG 4.
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    FIG 4.

    Postoperative patient with Chiari I with 19 HIF, 3 AMFs, and 2 AMF>HIF, with a faintly hyperintense ventral line at C6–T1.

Tables

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    Table 1:

    Age, sex, incidence (%), and frequency (No./Pt), for HIF, AMF, SL, and AMF>HIF in the Chiari I and non-Chiari I control groups

    Age (Median)Sex (F) (%)HIF (%)HIF/Pt.AMF (%)AMF/Pt.SL (No.) (%)AMF>HIF (Mean)
    Chiari I (n = 25)4023 (92%)25 (100%)8.5a24 (96%)4.0b14c (56%)2.2
    Control (n = 25)4017 (68%)24 (96%)3.9a22 (88%)2.7b7c (28%)1.0
    • ↵a P = .0004.

    • ↵b P = .025.

    • ↵c P < .02 (χ2).

    • View popup
    Table 2:

    Incidence HIF and AMF/pt., SL incidence, and number of AMFs extending to HIF (AMF>HIF) in Chiari I without an operation versus patients having undergone postdecompressive craniectomy

    HIFAMFSLAMF>HIF
    %HIF/Pt.%AMF/Pt.No. (%)No.
    Chiari I no surgery (n = 15)1008.91004.05 (33%)a1.9b
    Chiari I post-op (n = 10)1008.1904.38 (80%)a2.8b
    • Note:—Post-op indicates postoperative.

    • ↵a P = .009.

    • ↵b P = .07.

    • View popup
    Table 3:

    Number patients, HIF/pt., AMF/pt., HIF to AMF ratio, and AMF>HIF/pt. in HIF or AMF-only, HIF+AMF, and AMF>HIF subgroups for all Chiari I and control groups, with and without SL

     No.HIF/Pt.AMF/Pt.RatioAMF>HIF
    All Chiari I258.64.12.12.2
    All control253.92.71.41
    All Chiari I and controls
     HIF only
      Chiari I17NANA2.3
      Control112NANA1.0
     AMF only0NANANANA
     HIF+AMF
      Chiari I248.64.32.02.1
      Control233.931.31.1
      AMF-HIF
      Chiari I227.94.71.72.5
      Control164.43.31.31.5
     No AMF→HIF
      Chiari I313.71.78.20
      Control931.71.80
     SL
      Chiari I1410.14.62.22.9
      Control773.42.11.3
     HIF+AMF
      Chiari I1410.14.62.22.2
      Control66.241.61.5
     AMF-HIF
      Chiari I128.651.72.9
      Control57.241.81.8
     No SL
      Chiari I116.63.51.91.9
      Control182.72.41.10.8
     HIF+AMF
      Chiari I116.83.91.72.1
      Control172.930.90.9
     AMF-HIF
      Chiari I974.21.72.2
      Control113.131.11.2
    • Note:—NA indicates not applicable.

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American Journal of Neuroradiology: 42 (4)
American Journal of Neuroradiology
Vol. 42, Issue 4
1 Apr 2021
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T.A. Tomsick, L.L. Wang, M. Zuccarello, A.J. Ringer
MRI T2-Hyperintense Signal Structures in the Cervical Spinal Cord: Anterior Median Fissure versus Central Canal in Chiari and Control—An Exploratory Pilot Analysis
American Journal of Neuroradiology Apr 2021, 42 (4) 801-806; DOI: 10.3174/ajnr.A7046

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MRI T2-Hyperintense Signal Structures in the Cervical Spinal Cord: Anterior Median Fissure versus Central Canal in Chiari and Control—An Exploratory Pilot Analysis
T.A. Tomsick, L.L. Wang, M. Zuccarello, A.J. Ringer
American Journal of Neuroradiology Apr 2021, 42 (4) 801-806; DOI: 10.3174/ajnr.A7046
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