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Article: Forward shifting of posterior dural sac during flexion cervical magnetic resonance imaging in Hirayama disease: An initial study on normal subjects compared to patients with Hirayama disease
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TitleForward shifting of posterior dural sac during flexion cervical magnetic resonance imaging in Hirayama disease: An initial study on normal subjects compared to patients with Hirayama disease
 
AuthorsLai, V1
Wong, YC1
Poon, WL1
Yuen, MK1
Fu, YP1
Wong, OW1
 
KeywordsFunctional cervical spine MR imaging
Hirayama disease
Loss of attachment of posterior dural sac
 
Issue Date2011
 
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/ejrad
 
CitationEuropean Journal Of Radiology, 2011, v. 80 n. 3, p. 724-728 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ejrad.2010.07.021
 
AbstractObjective: Forward shifting of the posterior cervical dural sac is the most important sign in diagnosing Hirayama disease but can also be seen in normal subjects, causing potential diagnostic dilemma. We aim to explore the degree of forward displacement of posterior dural sac in normal subjects compared to that with Hirayama disease. Materials and methods: 50 healthy male teenagers and 3 patients with Hirayama disease were recruited into the control group and patient group, respectively. MR imaging of the cervical spine was performed in both neutral and flexion positions for all subjects, with the following parameters measured: maximal distance of forward shifting of posterior dural sac, dimension of dural sac and spinal cord. Results: Forward shifting of the posterior cervical dural sac was depicted in 46% of normal subjects upon flexion position but without associated cord compression due to intrinsic expansion of the spinal canal volume. This intrinsic compensatory mechanism was inadequate in diseased patients leading to cord compression with significant increment in ratio of anteroposterior diameter of forward displacement of posterior dural wall/anteroposterior diameter of spinal canal ("x/y"), and decrement in ratio of anteroposterior diameter of spinal cord/perpendicular transverse diameter of spinal cord ("a/b"). Conclusion: Depicting of forward shifting of posterior dural sac alone on flexion position cannot reliably diagnose Hirayama disease, which should be established only if there is forward shifting of posterior dural sac, plus increased ratio of x/y and decreased ratio of a/b on flexion position from associated mass effect on the spinal cord. © 2010 Elsevier Ireland Ltd.
 
ISSN0720-048X
2013 Impact Factor: 2.160
2013 SCImago Journal Rankings: 1.060
 
DOIhttp://dx.doi.org/10.1016/j.ejrad.2010.07.021
 
ISI Accession Number IDWOS:000296763300085
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLai, V
 
dc.contributor.authorWong, YC
 
dc.contributor.authorPoon, WL
 
dc.contributor.authorYuen, MK
 
dc.contributor.authorFu, YP
 
dc.contributor.authorWong, OW
 
dc.date.accessioned2011-12-21T08:48:33Z
 
dc.date.available2011-12-21T08:48:33Z
 
dc.date.issued2011
 
dc.description.abstractObjective: Forward shifting of the posterior cervical dural sac is the most important sign in diagnosing Hirayama disease but can also be seen in normal subjects, causing potential diagnostic dilemma. We aim to explore the degree of forward displacement of posterior dural sac in normal subjects compared to that with Hirayama disease. Materials and methods: 50 healthy male teenagers and 3 patients with Hirayama disease were recruited into the control group and patient group, respectively. MR imaging of the cervical spine was performed in both neutral and flexion positions for all subjects, with the following parameters measured: maximal distance of forward shifting of posterior dural sac, dimension of dural sac and spinal cord. Results: Forward shifting of the posterior cervical dural sac was depicted in 46% of normal subjects upon flexion position but without associated cord compression due to intrinsic expansion of the spinal canal volume. This intrinsic compensatory mechanism was inadequate in diseased patients leading to cord compression with significant increment in ratio of anteroposterior diameter of forward displacement of posterior dural wall/anteroposterior diameter of spinal canal ("x/y"), and decrement in ratio of anteroposterior diameter of spinal cord/perpendicular transverse diameter of spinal cord ("a/b"). Conclusion: Depicting of forward shifting of posterior dural sac alone on flexion position cannot reliably diagnose Hirayama disease, which should be established only if there is forward shifting of posterior dural sac, plus increased ratio of x/y and decreased ratio of a/b on flexion position from associated mass effect on the spinal cord. © 2010 Elsevier Ireland Ltd.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationEuropean Journal Of Radiology, 2011, v. 80 n. 3, p. 724-728 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ejrad.2010.07.021
 
dc.identifier.citeulike7765707
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.ejrad.2010.07.021
 
dc.identifier.epage728
 
dc.identifier.hkuros197940
 
dc.identifier.isiWOS:000296763300085
 
dc.identifier.issn0720-048X
2013 Impact Factor: 2.160
2013 SCImago Journal Rankings: 1.060
 
dc.identifier.issue3
 
dc.identifier.pmid20727701
 
dc.identifier.scopuseid_2-s2.0-80755188096
 
dc.identifier.spage724
 
dc.identifier.urihttp://hdl.handle.net/10722/143749
 
dc.identifier.volume80
 
dc.languageeng
 
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/ejrad
 
dc.publisher.placeIreland
 
dc.relation.ispartofEuropean Journal of Radiology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshCervical Vertebrae - pathology
 
dc.subject.meshDura Mater - pathology
 
dc.subject.meshMagnetic Resonance Imaging - methods
 
dc.subject.meshReproducibility of Results
 
dc.subject.meshSpinal Muscular Atrophies of Childhood - pathology
 
dc.subjectFunctional cervical spine MR imaging
 
dc.subjectHirayama disease
 
dc.subjectLoss of attachment of posterior dural sac
 
dc.titleForward shifting of posterior dural sac during flexion cervical magnetic resonance imaging in Hirayama disease: An initial study on normal subjects compared to patients with Hirayama disease
 
dc.typeArticle
 
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Author Affiliations
  1. Tuen Mun Hospital