Magnetic resonance imaging evaluation of acute spine trauma |
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Authors: | William W Orrison Jr MD Edward C Benzel MD Brian K Willis MD Blaine L Hart MD Mary C Espinosa RN |
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Institution: | (1) Department of Neurology, University of New Mexico School of Medicine, Albuquerque, New Mexico;(2) Department of Surgery/Division of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico;(3) Louisiana State University Medical Center, Shreveport, Louisiana;(4) Department of Radiology, University of New Mexico, 87131-5336 Albuquerque, NM |
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Abstract: | A comparison study of magnetic resonance imaging (MR), computed tomography (CT), and plain film evaluation of 113 consecutive
spine trauma cases was conducted. The rate of true-positive findings (sensitivity) on MR was shown to be significantly higher
than for CT or plain films in the evaluation of soft tissue or ligamentous injury (P<0.001). MR had a significantly lower
rate of positive findings for fracture than CT (P<0.001) and was also shown to be significantly less sensitive for fracture
than plain films (P<0.001). Spinal cord contusion, epidural hematoma, high-grade stenosis, and ligamentous or soft tissue
injury were best evaluated with MR.
MR, CT, and plain films are all important modalities for the evaluation of acute spine trauma. It is recommended that, after
clinical examination, patients with spine trauma be evaluated first by plain film. If there is clinical or radiologic suspicion
for acute spine injury, MR should be the next diagnostic procedure performed. If MR is positive for acute injury, CT may be
indicated. CT best defines the extent of bony injury, and MR the extent of soft tissue injury, intrinsic spinal cord pathology,
and extrinsic dural sac compression. |
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Keywords: | Plain films CT MR Fracture Ligamentous injury Cord injury |
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