Hirayama Flexion Myelopathy: Neutral-Position MR Imaging Findings - Importance of Loss of Attachment

Chi Jen Chen, Hui-Ling Hsu, Ying Chi Tseng, Rong Kuo Lyu, Chiung Mei Chen, Ying Chih Huang, Li Jen Wang, Yon Cheong Wong, Lai Chu See

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

PURPOSE: To investigate the sensitivity and specificity of various neutral-position magnetic resonance (MR) imaging findings in the diagnosis of Hirayama flexion myelopathy. MATERIALS AND, METHODS: The neutral-position cervical MR images of 46 patients and 51 control subjects were evaluated for the following findings: localized lower cervical cord atrophy, asymmetric cord flattening, abnormal cervical curvature, loss of attachment (LOA) between the posterior dural sac and subjacent lamina, and noncompressed intramedullary high signal intensity on T2-weighted MR images. The difference in frequency of these findings between the control and patient groups was examined by means of the χ2 test. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of these MR imaging findings in the diagnosis Hirayama disease were calculated. Multivariate analysis of these findings was also performed. RESULTS: There was a significant difference in the frequency of these MR imaging findings between the control and patient groups (all comparisons, P ≤ .002). Among the MR imaging findings, localized lower cervical cord atrophy, asymmetric cord flattening, and LOA had accuracy of more than 80% in identification of the disease. After multivariate analysis, LOA was the only significantly important predictor of the disease, with odds ratio of 716.7 (95% CI: 71.9, 7,145.2). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of LOA were 93.5%, 98.0%, 97.7%, 94.3%, and 95.9%, respectively. CONCLUSION: LOA from posterior dural sac and subjacent lamina is the most valuable finding in the diagnosis of Hirayama disease at neutral-position MR imaging.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalRadiology
Volume231
Issue number1
DOIs
Publication statusPublished - Apr 2004
Externally publishedYes

Keywords

  • Muscles, diseases
  • Spinal cord, diseases
  • Spinal cord, MR

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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    Chen, C. J., Hsu, H-L., Tseng, Y. C., Lyu, R. K., Chen, C. M., Huang, Y. C., Wang, L. J., Wong, Y. C., & See, L. C. (2004). Hirayama Flexion Myelopathy: Neutral-Position MR Imaging Findings - Importance of Loss of Attachment. Radiology, 231(1), 39-44. https://doi.org/10.1148/radiol.2311030004