Rofo 2006; 178 - RK_316_4
DOI: 10.1055/s-2006-940540

Imaging in spinal injuries

M Forsting 1, S Mutze 1
  • 1Universitätsklinik Essen, Institut f Diagnostische u. Intervent. Radiologie, Essen

MRI is the diagnostic method of choice in patients with a suspicion of spinal cord injuries. And in fact, this is one of the rare emergency indications for MR in general.

Nowadays it cannot be justified anymore to follow the older step-by-step diagnostic work-up starting with plain radiographs and finally ending with MR. Patients with a neurological problem after a relevant trauma related to the spine just need a MR scan.

Although the presence of spinal cord intramedullary lesions detected at MRI have prognostic implications for the patients, surgical treatment usually is provided in the acute setting only for extramedullary abnormalities (hematoma, retropulsed bone fragments,and traumatic discs herniation) that compress the spinal cord. Bony injuries do not accurately correlate with neurology findings in more than 65% of instances of trauma, especially among children. Hemorrhagic contusions have a poor prognosis with little likelihood of recovery. Nonhemorrhagic contusions produce edema, have normal T1 signal and have a moderately good prognosis. The radiologist should always image the whole vertebral column and always have a serious lool at the craniocervikal region.

Lernziele:

  • To realize that MR is the first diagnostic method of choice in patients with neurological deficits after a spine trauma

  • To realize that spinal MRI is an emergency examination after a trauma, if the patient has neurological deficits

  • To differentiate at least three different compartments when reporting about the spine, the spinal column and the vertrebra.

Korrespondierender Autor: Forsting M

Universitätsklinik Essen, Institut f Diagnostische u. Intervent. Radiologie, Hufelandstraße 55, 45122 Essen

E-Mail: m.forsting@uni-essen.de