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DOI: 10.1590/0004-282X20180042
Pancake-like gadolinium enhancement in the spinal cord: an image pattern that suggests spondylotic myelopathy
Realce pelo gadolínio “em panqueca” na medula espinhal: um padrão de imagem sugestivo de mielopatia espondilóticaA 55-year-old man without comorbidities presented with progressive paresthesia and weakness affecting the limbs. Cervical magnetic resonance imaging (MRI) demonstrated prominent spondylosis and myelopathy with pancake-like gadolinium enhancement ([Figures 1] and [2]).
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The pancake-like sign is related to a focal disruption of the blood-brain barrier and defined by a circumferential enhancement sparing spinal cord gray matter on axial images, located beneath the site of maximum stenosis, with a transverse band appearance on sagittal images, extending less than one vertebral segment. The recognition of these radiological findings contribute to the avoidance of unnecessary interventions[1],[2],[3].
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Conflict of interest:
There is no conflict of interest to declare.
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References
- 1 Seidenwurm DJ. Myelopathy. Am J Neuroradiol. 2008;29(5):1032-4.
- 2 Flanagan EP, Krecke KN, Marsh RW, Giannini C, Keegan M, Weinshenker BG. Specific pattern of gadolinium enhancement in spondylotic myelopathy. Ann Neurol. 2014;76(1):54-65. https://doi.org/10.1002/ana.24184
- 3 Flanagan EP, Marsh RW, Weinshenker BG. Teaching neuroimages: “pancake-like” gadolinium enhancement suggests compressive myelopathy due to spondylosis. Neurology. 2013;80(21):e229. https://doi.org/10.1212/WNL.0b013e318293e346
Address for correspondence
Publication History
Received: 08 January 2018
Accepted: 06 February 2018
Article published online:
25 August 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Seidenwurm DJ. Myelopathy. Am J Neuroradiol. 2008;29(5):1032-4.
- 2 Flanagan EP, Krecke KN, Marsh RW, Giannini C, Keegan M, Weinshenker BG. Specific pattern of gadolinium enhancement in spondylotic myelopathy. Ann Neurol. 2014;76(1):54-65. https://doi.org/10.1002/ana.24184
- 3 Flanagan EP, Marsh RW, Weinshenker BG. Teaching neuroimages: “pancake-like” gadolinium enhancement suggests compressive myelopathy due to spondylosis. Neurology. 2013;80(21):e229. https://doi.org/10.1212/WNL.0b013e318293e346
![](https://www.thieme-connect.de/media/10.1055-s-00054595/201806/thumbnails/10-1590-0004-282x20180042-i20180042-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/10.1055-s-00054595/201806/thumbnails/10-1590-0004-282x20180042-i20180042-2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)