Cervical spine MR imaging findings of patients with Hirayama disease in North America: A multisite study

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Abstract

BACKGROUND AND PURPOSE: Most studies of HD have been conducted in Asia, particularly Japan. To characterize the MR imaging findings of North American patients with HD, we reviewed neutral and flexion cervical MR imaging examinations performed for possible HD at 3 academic medical centers located in the Southeastern, Southwestern, and Midwestern regions of the United States. MATERIALS AND METHODS: Three neuroradiologists assessed the MR imaging examinations in a blinded fashion and reached a consensus rating for LOA of the posterior dura to the spine, lower spinal cord atrophy, spinal cord T2 hyperintensity, loss of cervical lordosis, anterior dural shift with flexion, and confidence of imaging diagnosis. Final reference diagnosis was established separately with a retrospective chart review by a neurologist. RESULTS: Twenty-one patients met the criteria for HD, all were North American males and all who reported their race were white. Seventeen patients did not meet the criteria and served as controls. Four imaging attributes, LOA, dural shift with flexion, consensus diagnosis of neutral images, and consensus diagnosis of combined neutral and flexion images were all able to discriminate the group with HD from the group without HD (P < .05 for each). Findings of HD were often present on neutral images, but the addition of flexion images increased diagnostic confidence. CONCLUSIONS: MR imaging findings in white North American patients with HD include LOA on neutral images and forward displacement of the dura with flexion. Findings are often present on neutral MR images and, in the appropriate clinical scenario, should prompt flexion MR imaging to evaluate anterior dural shift.

Original languageEnglish (US)
Pages (from-to)451-456
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume34
Issue number2
DOIs
StatePublished - Feb 2013

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North America
Spine
Spinal Cord
Midwestern United States
Lordosis
Atrophy
Japan
Monomelic amyotrophy

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Cervical spine MR imaging findings of patients with Hirayama disease in North America: A multisite study",
abstract = "BACKGROUND AND PURPOSE: Most studies of HD have been conducted in Asia, particularly Japan. To characterize the MR imaging findings of North American patients with HD, we reviewed neutral and flexion cervical MR imaging examinations performed for possible HD at 3 academic medical centers located in the Southeastern, Southwestern, and Midwestern regions of the United States. MATERIALS AND METHODS: Three neuroradiologists assessed the MR imaging examinations in a blinded fashion and reached a consensus rating for LOA of the posterior dura to the spine, lower spinal cord atrophy, spinal cord T2 hyperintensity, loss of cervical lordosis, anterior dural shift with flexion, and confidence of imaging diagnosis. Final reference diagnosis was established separately with a retrospective chart review by a neurologist. RESULTS: Twenty-one patients met the criteria for HD, all were North American males and all who reported their race were white. Seventeen patients did not meet the criteria and served as controls. Four imaging attributes, LOA, dural shift with flexion, consensus diagnosis of neutral images, and consensus diagnosis of combined neutral and flexion images were all able to discriminate the group with HD from the group without HD (P < .05 for each). Findings of HD were often present on neutral images, but the addition of flexion images increased diagnostic confidence. CONCLUSIONS: MR imaging findings in white North American patients with HD include LOA on neutral images and forward displacement of the dura with flexion. Findings are often present on neutral MR images and, in the appropriate clinical scenario, should prompt flexion MR imaging to evaluate anterior dural shift.",
author = "Lehman, {Vance T} and Luetmer, {Patrick H} and Sorenson, {Eric James} and Carter, {Rickey E.} and V. Gupta and Fletcher, {G. P.} and Hu, {Leland S} and Kotsenas, {A. L.}",
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AU - Lehman, Vance T

AU - Luetmer, Patrick H

AU - Sorenson, Eric James

AU - Carter, Rickey E.

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AU - Hu, Leland S

AU - Kotsenas, A. L.

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