EPIDURAL VENOUS SYSTEM (MENINGORACHIDIAN VENOUS PLEXUS) IN JUVENILE AMYOTROPHY OF DISTAL UPPER EXTREMITY - ASSESSMENT WITH GD-DTPA ENHANCED VOLUMETRIC MR STUDY

The epidural venous system (meningorachidian venous plexus) was analyzed utilizing gadolinium-diethylenetriamene pentaacetic acid (DTPA) (Gd-DTPA) enhanced volumetric magnetic resonance (MR) images in 11 patients with focal cervical spinal cord atrophy, clinically consistent with juvenile amyotrophy of distal upper extremity. In our series, all of the patients showed unusual posterior epidural venous enhancement at the C5-6 level, suggesting posterior epidural venous dilatation. Three patients also showed prominent dilatation of cervico-thoracic epidural veins surrounding the thecal sac. These MR findings were also demonstrated by spinal phlebography. Gd-DTPA enhanced MR images, especially high resolutional volumetric MR images, were efficient for evaluating these vessels. The observation of meningorachidian venous plexus along the disease course should be necessary for searching the pathogenesis of this disease.