High signal intensity on T1 weighted MRI of the anterolateral column of the spinal cord in amyotrophic lateral sclerosis.

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Abstract
OBJECTIVE: To investigate MRI abnormalities in patients with amyotrophic lateral sclerosis. METHODS: Fourteen patients with amyotrophic lateral sclerosis underwent MRI of the head and spinal cord using T1 and T2 weighted images. Forty age matched controls (29 with other neurological diseases, 11 with non-neurological diseases) underwent MRI of the cervical spinal cord using T1 and T2 weighted images. RESULTS: In all the control patients, the signal intensity of the posterior column was equal or slightly hypointense compared with the anterolateral column of the cervical spinal cord on T1 weighted images. However, eight of 14 patients with amyotrophic lateral sclerosis showed pronounced high signal intensity in the anterolateral column of the spinal cord on T1 weighted MRI, which also disclosed high signal intensity of the intracranial corticospinal tract in two of the 14 patients. T2 weighted MRI demonstrated high signal intensity of the lateral corticospinal tract of the spinal cord in two, high signal intensity of the intracranial corticospinal tract in five, and low signal intensity of the motor cortex in six of the 14 patients. Two of the 14 patients showed no abnormal findings on MRI. CONCLUSIONS: High signal intensity of the anterolateral column of the spinal cord of patients with amyotrophic lateral sclerosis is a new imaging abnormality and may be useful for the diagnosis of this disease.