50th SMRT Educational Seminar Home Study

"The aim of the article is to review the common conditions causing high T2-weighted image signal in the spinal cord and outline an approach to diagnosis with reference to pertinent imaging features."

Anne Marie Sawyer, B.S., R.T.(R)(MR), FSMRT, Editor


We are pleased to present the SMRT Educational Seminars, Volume 13, Number 4: “MRI of Spinal Cord Lesions.” This is the 50th accredited home study developed by the SMRT, exclusively for the SMRT members. The accreditation is conducted by the SMRT that acts as a RCEEM (Recognized Continuing Education Evaluation Mechanism) for the ARRT. Category A credits are assigned to each educational symposia, which can be used to maintain one’s ARRT registry. For this issue, we have selected two articles that were recommended by SMRT past president, Wendy Strugnell of Brisbane, Queensland, Australia. These articles, both written by the same authors, review the "Differential diagnosis of T2 hyperintense spinal cord lesions." Together, these articles provide what we feel is a most comprehensive and informative discussion regarding these types of lesions.

As stated by the authors, "Hyperintense spinal cord signal on T2-weighted images is seen in a wide-ranging variety of spinal cord processes including: simple MR artifacts, congenital anomalies and most disease categories. Characterization of the abnormal areas of T2 signal as well as their appearance on other MR imaging sequences, when combined with clinical context and laboratory investigations, will often allow a unique diagnosis, or at least aid in narrowing the differential diagnosis." The cases discussed in the first article, part A, include compression and trauma, neoplasms, radiation myelitis, and congenital conditions.

According to the authors, "An abnormal signal in the spinal cord can be characterized according to its location, extent, multiplicity, internal signal characteristics, presence or absence of mass effect, appearance on other MR imaging sequences, degree of enhancement after administration of gadolinium-based contrast agents and correlation with clinical history." In the second article, Part B, the topics include multiple sclerosis, subacute combined degeneration of the spinal cord, cord infarction, arteriovenous shunts, transverse myelitis, neurosarcoidosis, AIDS-associated vacuolar myelopathy, and syringohydromyelia.

Many thanks to Wendy Strugnell for recommending the articles and to John Totman, SMRT Publications Chair from Nottingham, UK, for his support and continuing direction of the SMRT Publications Committee.

Thanks to Cindy Hipps, BHS, R.T.(R)(MR), FSMRT from Greenville, South Carolina, USA for acting as our Expert Reviewer for this home study issue and the accompanying quiz that provides the continuing education credits.
Thanks also to Jennifer Olson, Associate Executive Director, Mary Keydash, Publications Director, and the staff in the Berkeley, California, USA office of the ISMRM/SMRT for their insight and long hours supporting these educational symposia.

We would especially like to thank John Wilkie and all of the people at Invivo Corporation who generously support our home studies program, the SMRT Educational Seminars. Their continuing investment advancing technologist and radiographer knowledge brings quality continuing education to the SMRT membership worldwide.