Acute Cervical Spine Injuries: Prospective MR Imaging Assessment at a Level 1 Trauma Center

Katzberg, Richard W.; Benedetti, Philip F.; Drake, Christiana; Ivanović, Marija; Levine, Richard A.; Beatty, Carol S.; Nemzek, William R.; McFall, Russell A.; Ontell, Francesca K.; Bishop, D. M.; Poirier, Virginia C.; Chong, Brian W.

doi:10.1148/radiology.213.1.r99oc40203

Cited by 130 publications

(56 citation statements)

References 20 publications

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“…[2][3][4][5][6][7] In our study, whole spine ADC, FA, and RA values were most significantly reduced and VR was increased significantly for patients with cord hemorrhage. These changes were noted on a regional basis when compared with the control group.…”

mentioning

confidence: 77%

“…1 Conventional MR imaging is performed routinely to demonstrate soft-tissue and spinal cord injuries in spinal trauma. [2][3][4] Edema and hemorrhage in the spinal cord following trauma are well demonstrated by MR imaging and may help to predict neurologic outcomes. [5][6][7] Diffusion-weighted MR imaging (DWI) assesses in vivo changes in random motion of protons in water.…”

mentioning

confidence: 99%

“…These findings are consistent with the observation that cord contusions in patients with quadriplegia as seen on conventional MR imaging usually extend over multiple levels and involve a large area of the transverse diameter of the cord. [2][3][4][5][6][7] Previous animal studies have noted significant differences in transverse and longitudinal diffusivity between white matter tracts within the spinal cord. 16 These differences may be the result of changes in axonal diameters seen within the various white matter tracts.…”

mentioning

confidence: 99%

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Diffusion Tensor MR Imaging in Cervical Spine Trauma

Shanmuganathan¹,

Gullapalli²,

Zhuo³

et al. 2008

AJNR Am J Neuroradiol

154

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mentioning

confidence: 77%

mentioning

confidence: 99%

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confidence: 99%

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Diffusion Tensor MR Imaging in Cervical Spine Trauma

Shanmuganathan¹,

Gullapalli²,

Zhuo³

et al. 2008

AJNR Am J Neuroradiol

154

View full text Add to dashboard Cite

show abstract

“…[7][8][9][10][11][12] For our study, the ADL was considered torn if a focal area of ALL/disk discontinuity could be identified on sagittal T2 or inversion recovery sequences. To further improve our specificity, we excluded patients if a focal point of ligament/disk discontinuity could not be definitively identified or if there was not agreement between the 2 neuroradiologists regarding the presence of ADL disruption.…”

Section: Patient Selection and Image Acquisitionmentioning

confidence: 99%

Evaluation of the Intervertebral Disk Angle for the Assessment of Anterior Cervical Diskoligamentous Injury

Alhilali

Fakhran

2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The anterior diskoligamentous complex is important for cervical spinal stability. Subjective widening of the disk space after trauma has been used to gauge disruption of the anterior diskoligamentous complex on CT scanning, but no quantitative CT measurements exist to evaluate injury. The purpose of our study was to evaluate if an increased intervertebral disk angle could serve as a more sensitive, reproducible indicator of disruption of the anterior diskoligamentous complex compared with subjective assessment.

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“…Each radiologist documented his results into positive or negative restricted diffusion for infarction via analysis of restricted DWI & ADC mapping, blooming artifact seen on gradient sequencing, perfusion deficit as determined by analysis of cerebral blood flow, cerebral blood volume, and mean transit time [38][39][40][41][42][43]. In addition, other CNS pathologic etiologies were assayed including: intracranial hemorrhage, spinal cord compression, fracture, spinal canal stenosis, neural foraminal stenoses, disk herniation, and annular fissuring [24,[44][45][46][47].…”

Section: Methodsmentioning

confidence: 99%

Intra and Inter-Observer Reliability of Mobile Tablet PACS Viewer System vs. Standard PACS Viewing Station-Diagnosis of Acute Central Nervous System Events

Bhatia¹,

Patel²,

Pantol³

et al. 2013

OJRad

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Background and Purpose: The display resolution of the Apple iPad® is 1024 × 768 pixels, which is greater than that required for generating the typical CT or MRI images. The purpose of this study is to determine if specific CT and MR sequences can be interpreted accurately on mobile device/PACS software platforms when compared to a traditional stationary high resolution monitor/PACS radiological workstation. If so, this allows radiologists to provide comparable interpretation as if they were onsite at an imaging center or hospital. Materials and Methods: This study is an investigator initiated, single site, retrospective, nonrandomized, IRB approved study. Five radiologists were included in this study. Each independently interpreted specific CT and MR sequences on traditional high-resolution LCD monitors via eFilm® software as well as an iPad® mobile device using Osirix® software program. Repeat interpretations were performed, with 4 weeks minimum interval between interpretations of each patient. This investigation included: 50 patients with CTA perfusion imaging, 50 patients with MRI of the brain, and 50 patients with MRI of the spine, which were image study orders generated through emergency room requests. Subsequently, interpretive results of each radiologist for each patient were statistically compared to evaluate for intra-observer and inter-observer reliability. Results: The parameters set within the CTA perfusion brain studies demonstrated excellent intra-observer variability. All of the parameters within the MRI brain studies demonstrated excellent intra-observer variability with a Cohen's kappa value > 0.75. The Cohen's kappa values for the board certified neuroradiologist demonstrated excellent variability for all parameters; the resident radiologists had good variability, with a majority of kappa values near 0.75. Conclusions: The data and statistical analysis demonstrated that portable mobile devices such as the Apple iPad® can display adequate resolution of CT and MRI sequences to accurately diagnose acute central nervous system injuries and other non-acute pathology.

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Acute Cervical Spine Injuries: Prospective MR Imaging Assessment at a Level 1 Trauma Center

Abstract: MR imaging is more accurate than radiography in the detection of a wide spectrum of neck injuries, and further study is warranted of its potential effect on medical decision making, clinical outcome, and cost-effectiveness.

Cited by 130 publications

References 20 publications

Diffusion Tensor MR Imaging in Cervical Spine Trauma

Diffusion Tensor MR Imaging in Cervical Spine Trauma

Evaluation of the Intervertebral Disk Angle for the Assessment of Anterior Cervical Diskoligamentous Injury

Intra and Inter-Observer Reliability of Mobile Tablet PACS Viewer System vs. Standard PACS Viewing Station-Diagnosis of Acute Central Nervous System Events

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