PMC6000836_01
MRI of the cervical spine: initial MRI at symptom onset: (a) sagittal T2W/TSE (TR 3800 ms, TE 108 ms); (b) sagittal T2W/STIR (TR 4000 ms, TE 39 ms). Images show a hypointense oblong lesion in the spinal cord at the level of C6-C7 (empty arrows). Above and below the lesion the spinal cord shows hyperintense signal consistent with myelitis (filled arrows). Follow-up MRI 10 months later: (c) sagittal T2W/TSE (TR 3800 ms, TE 108 ms) and (d) sagittal T2W/STIR (TR 4000 ms, TE 39 ms). Follow-up images show normal spinal cord appearance following the resolution of myelitis and the same hypointense glass lesion (empty arrows).
CRINM2018-5129513.001.jpg
PMC6000836_01_CRINM2018-5129513.001.jpg
fig1
At the level of C4-Th3 the spinal cord was thickened and hyperintense on T2W images, features consistent with myelitis; however there was no appreciable contrast uptake (Figures 1(a) and 1(b)). At the level of C6-C7 an oblong (1.6 x 0.4 cm), T1 and T2 hypointense lesion was found (Figure 1). Follow-up MRI of the cervical spine shows the same oblong hypointense object and normal spinal cord after the resolution of myelitis (Figures 1(c) and 1(d)).
CT of the cervical spine: bone windows, axial (a) and sagittal reconstruction (b) showing a hyperdense oblong lesion at the level of C6-C7 in the left intervertebral foramen and spinal canal (arrows).
CRINM2018-5129513.002.jpg
PMC6000836_01_CRINM2018-5129513.002.jpg
fig2
Because a foreign body was suspected, CT scan of the C1-Th3 levels was performed and demonstrated a hyperdense lesion occupying the spinal canal and the left intervertebral foramen (Figure 2).
X-ray of the cervical spine. The foreign body is not visible in posteroanterior (a) and lateral (b) views.
CRINM2018-5129513.003.jpg
PMC6000836_01_CRINM2018-5129513.003.jpg
fig3
The patient also had an X-ray of the cervical spine but the foreign body could not be visualized, most likely due to being located at the level of C6-C7, where it was obscured by the surrounding structures (Figure 3).