MR Imaging of Acute Transverse Myelitis and AIDS Myelopathy

Acute transverse myelitis (ATM) is a well recognized clinical entity, though its etiology remains obscure. Only a few reports of magnetic resonance imaging of ATM appear in the literature. These reports describe conflicting findings with respect to the signal intensity of the spinal cord on long repetition time (TR) sequences. The purpose of this study is to present our experience with five cases of ATM in which long TR sequences demonstrated abnormal increase in signal intensity of the cord. Magnetic resonance imaging also demonstrated extension of abnormal cord signal intensity over at least six spinal segments and above the clinically determined sensory level in four of five cases. Cord expansion was noted in two of five cases with normal myelograms. A case of acquired immunodeficiency syndrome (AIDS) myelopathy that demonstrated a similar high signal intensity of the cord is also presented. Our findings suggest that both ATM and AIDS myelopathy should be considered in the list of conditions that may result in a diffuse increase in the signal intensity of the cord on long TR sequences.