Analysis Of The Clinical And MRI Characteristics In Patient With Acute Transverse Myelitis

ObjectiveAcute transverse myelitis is a complex pathophysiology syndrome. The typical clinical manifestation of acute transverse myelitis is transverse injury of spinal cord. Despite the low incidence of this disease, the prognosis is quite different.Even to be active treatment,long-term follow-up studies have shown that nearly a third of patients will still have left permanent severe neurological dysfunction.It can reduce the quality of life of patients,and also bring a heavy burden on families and society. If it can diagnosis and treatment as early and timely,its disability rate will significantly reduce. In this study,our aim is to investigate the clinical and MRI features of ATM with first episode, then assist in the diagnosis and treatment of the disease and prognosis.MethodsAccording to the diagnostic criteria of ATM in 2002 developed by the transverse myelitis consortium working group(TMCWG), we collected 56 ATM cases met the diagnostic criteria and had complete clinical information, and all patients with a follow-up duration longer than 2 years were identified. The clinical information and MRI features of 56 cases with ATM were analyzed retrospectively.Results1)56 cases of ATM patients must have had at least one follow-up visit more than 2 years after the onset of symptoms. 19 cases(33.9 %,19/56)for multiple sclerosis(MS),10 cases(17.9%,10/56)for neuromyelitisoptica(NMO),3 cases(5.4%,3/56)for systemic autoimmune disease,4 cases(7.1%,4/56) for parainfectious and 20 cases(35.7%,20/56)for idiopathic were clinically defined.2)All patients had varying degrees of motor,sensory and autonomic dysfunction below the level of the cord lesions.3) MRI features : The cervical cord was involved in 18 cases.The thoracic cord was involved in 17 cases.The cervical and thoracic spinal cord was all involved in 13 cases.The thoracic and lumbar spinal cord was involved in 8 cases. 33 cases of lesions were associated with swelling,and in other 23 cases the spinal cord showed normal appearance. The average lesion length was 4.7 spinal segment.29 cases were involved more than two-thirds of the cross-sectional area of the spinal cord,27 cases occupied less than two-thirds of the cross-sectional area. Contrast-enhanced MR scanning demonstrated that non-enhancement was seen in 15 cases, patchy or strip enhancement were revealed in 41 cases.ConclusionThe combination of clinical characteristics and MRI features can improve the diagnosis and differential diagnosis with ATM.