Acute cervical spine trauma: evaluation with 1.5-T MR imaging

Area of Science:

• Neuroradiology
• Spinal Imaging
• Trauma Imaging

Background:

• Acute cervical spine trauma can cause significant neurologic deficits.
• Accurate imaging is crucial for diagnosing and managing these injuries.
• Multiple imaging modalities are available, each with potential strengths and weaknesses.

Purpose of the Study:

• To compare the diagnostic efficacy of various imaging techniques in patients with acute cervical spine trauma.
• To determine the optimal imaging modality for evaluating spinal cord injuries and associated pathologies.

Main Methods:

• Retrospective evaluation of 21 patients with acute neurologic deficits post-cervical spine trauma.
• Utilized magnetic resonance (MR) imaging (n=21), CT myelography (n=18), myelography (n=13), radiography (n=21), and intraoperative sonography (n=7).
• Compared findings for parenchymal spinal cord injury, disk herniation, and fractures.

Main Results:

• MR imaging demonstrated superior sensitivity for parenchymal spinal cord injuries and cervical intervertebral disk herniation.
• T2-weighted MR sequences were more effective than T1-weighted for detecting spinal cord injury.
• CT myelography showed superiority over MR imaging in identifying cervical spine fractures.
• Myelography provided limited additional information beyond CT and MR imaging.

Conclusions:

• MR imaging is the recommended initial imaging modality for evaluating clinically stable, symptomatic patients with acute cervical spine trauma.
• CT myelography remains essential for evaluating complex cervical spine fractures.
• A combination of MR imaging and CT may be necessary for comprehensive assessment.