Magnetic Resonance Imaging of Spinal Emergencies

Kawakyu-O’Connor, Daniel; Bordia, Ritu; Nicola, Refky

doi:10.1016/j.mric.2015.11.004

Cited by 25 publications

(18 citation statements)

References 36 publications

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“…However, there is no definite consensus on the exact MRI protocol to be used in patients suffering from such injury. A multi-sequence approach consisting of at least sagittal T1- and T2-weighted spin echo sequences and STIR sequences, supplemented by axial T2-weighted sequences tailored to the levels of pathology, seems routine [ 9 , 20 , 21 ]. Particularly STIR sequences have already been recommended as highly relevant for the evaluation of disco-ligamentous injuries, and particularly for damage to the ALL at the cervical spine [ 3 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Occult Disco-Ligamentous Lesions of the Subaxial c-Spine—A Comparison of Preoperative Imaging Findings and Intraoperative Site Inspection

et al. 2021

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Despite the general acceptance of magnetic resonance imaging (MRI) as the gold standard for diagnostics of traumatic disco-ligamentous injuries in the subaxial cervical spine, clinical experience shows cases where no lesion is detected in MRI exams but obtained during surgery. The aim of this study was to compare intraoperative site inspection to preoperative imaging findings and to identify radiological features of patients having a risk for under- or over-estimating disco-ligamentous lesions. We performed a retrospective analysis of our clinical database, considering all patients who underwent surgical treatment of the cervical spine via an anterior approach after trauma between June 2008 and April 2018. Only patients with availability of immediate preoperative computed tomography (CT), 3-Tesla MRI scans, and information about intraoperative findings were considered. Results of preoperative imaging were set in context to intraoperative findings, and receiver operator characteristics (ROC) were calculated. Out of 144 patients receiving anterior cervical surgery after trauma, 83 patients (mean age: 59.4 ± 20.5 years, age range: 12–94 years, 63.9% males) were included in this study. Included patients underwent surgical treatment via anterior cervical discectomy and fusion (ACDF; 79 patients) or anterior cervical corpectomy and fusion (4 patients) with ventral plating. Comparing preoperative imaging findings to intraoperative site inspection, a discrepancy between imaging and surgical findings was revealed in 14 patients, leading to an overall specificity/sensitivity of preoperative imaging to identify disco-ligamentous lesions of the cervical spine of 100%/77.4%. Yet, adding the existence of prevertebral hematoma and/or vertebral fractures according to preoperative imaging improved the sensitivity to 95.2%. Lack of sensitivity was most likely related to severe cervical spondylosis, rendering correct radiological reporting difficult. Thus, the risk of missing a traumatic disco-ligamentous injury of the cervical spine in imaging seems to be a particular threat in patients with preexisting degenerative cervical spondylosis. In conclusion, incorporating the existence of prevertebral hematoma and/or vertebral fractures can significantly improve diagnostic yield.

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Section: Discussionmentioning

confidence: 99%

Occult Disco-Ligamentous Lesions of the Subaxial c-Spine—A Comparison of Preoperative Imaging Findings and Intraoperative Site Inspection

et al. 2021

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“…The high costs and long run times for whole-spine examination do not make it a suitable examination for all patients. MRI diagnostic performance decreases in follow-up evaluation and in post-operative infection of the spine [2,[17][18][19][20][21][22][23]. These drawbacks, over time, lead many to look for other methods that could replace an MRI, mostly when it is contraindicated, not available, or doubtful [2,24,25].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Diagnostic Value of MRI and Whole Body 18F-FDG PET/CT in Diagnosis of Spondylodiscitis

Altini

Lavelli

Asabella

et al. 2020

JCM

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Spondylodiscitis is a spine infection for which a diagnosis by a magnetic resonance imaging (MRI) is considered the most appropriate imaging technique. The aim of this study was to compare the role of an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and an MRI in this field. For 56 patients with suspected spondylodiscitis for whom MRI and 18F-FDG PET/CT were performed, we retrospectively analyzed the results. Cohen’s κ was applied to evaluate the agreement between the two techniques in all patients and in subgroups with a different number of spinal districts analyzed by the MRI. Sensitivity, specificity, and accuracy were also evaluated. The agreements of the 18F-FDG PET/CT and MRI in the evaluation of the entire population, whole-spine MRI, and two-districts MRI were moderate (κ = 0.456, κ = 0.432, and κ = 0.429, respectively). In patients for whom one-district MRI was performed, 18F-FDG PET/CT and MRI were both positive and completely concordant (κ = 1). We also separately evaluated patients with suspected spondylodiscitis caused by Mycobacterium tuberculosis for whom the MRI and 18F-FDG PET/CT were always concordant excepting in 2 of the 18 (11%) patients. Sensitivity, specificity, and accuracy of the MRI and 18F-FDG PET/CT were 100%, 60%, 97%, and 92%, 100%, and 94%, respectively. Our results confirmed the 18F-FDG PET/CT diagnostic value in the diagnosis of spondylodiscitis is comparable to that of MRI for the entire spine evaluation. This could be considered a complementary technique or a valid alternative to MRI.

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“…1) besetzt und angefahren werden. [28,29]. Auch hierbei spielen Kinder eine herausgehobene Rolle infolge radiologisch okkulter, schwerer WS-Verletzungen mit substanziellen neurologischen Defiziten, mitunter ohne erkennbare radiografische Verletzungsmuster (SCIWORA-Konzept) [30,31] Letzteres wird gelegentlich auch bei erwachsenen und älteren Unfallopfern angetroffen (▶ Abb.…”

Section: Die Zentrale Lage Der Radiologie Am Klinikum Augsburg Erlaubunclassified

Logistische Materialvorhaltung der Polytraumaversorgung im Schockraum aus radiologischer Sicht

Grieser¹

2020

OP-JOURNAL

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Magnetic Resonance Imaging of Spinal Emergencies

Cited by 25 publications

References 36 publications

Occult Disco-Ligamentous Lesions of the Subaxial c-Spine—A Comparison of Preoperative Imaging Findings and Intraoperative Site Inspection

Occult Disco-Ligamentous Lesions of the Subaxial c-Spine—A Comparison of Preoperative Imaging Findings and Intraoperative Site Inspection

Comparison of the Diagnostic Value of MRI and Whole Body 18F-FDG PET/CT in Diagnosis of Spondylodiscitis

Logistische Materialvorhaltung der Polytraumaversorgung im Schockraum aus radiologischer Sicht

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