Due to the challenging nature of diagnosing intramedullary spinal cord abnormalities, magnetic resonance imaging is becoming the modality of choice for diagnosis and preoperative assessment of patients with spinal cord abnormalities. This article provides a systematic approach to the evaluation of intramedullary spinal cord lesions to help narrow the differential diagnosis. In doing so, it reviews various spinal cord pathologies, including demyelinating and metabolic conditions, neoplasms, and vascular lesions.
• Imaging diagnosis of intramedullary spinal cord lesions could obviate cord biopsy.
• Evaluation of cord lesions should focus on location, length, and enhancement pattern.
• In demyelination, the degree of cross-sectional involvement is a distinguishing feature.
Authors: Sarah Mohajeri Moghaddam, A. Bhatt