Multiple sclerosis in the spinal cord: MR appearance and correlation with clinical parameters

PURPOSE: To determine the characteristic magnetic resonance (MR) imaging features of multiple sclerosis (MS) that affect the spinal cord. MATERIALS AND METHODS: Sixty-eight patients underwent MR imaging of the cervical and/or thoracic spine. Plaques were analyzed for lesion length, cross-sectional area and location, signal intensity, and morphology. The clinical parameters of MS type, duration of disease, sex, and age were also correlated with these MR imaging findings. RESULTS: One hundred twenty-four demyelinating plaques were found in these 68 patients; 38 had more than one plaque. The majority of plaques were two body segments in length or less and peripherally located, and occupied less than 50% of the cross-sectional area of the cord. Plaques associated with cord atrophy were more likely to occur with the relapsing- progressive form of MS. Cord swelling was found only in the relapsing- remitting form of MS. CONCLUSION: Spinal cord MS plaques are characteristically peripherally located, are less than two vertebral segments in length, and occupy less than half the cross-sectional area of the cord.