MR imaging of acute cervical spinal ligamentous and soft tissue trauma

Abstract

The increasing availability of magnetic resonance imaging (MRI) and the high sensitivity of MRI for soft tissue injury are resulting in the increased use of MRI for the evaluation of acute trauma. As cervical spine injury can have a devastating consequence, MRI is being more commonly used to evaluate cervical spine injury in the acute setting, necessitating emergent interpretation by the on-call radiologist. Unless one is formally trained in a trauma center, the MRI findings of soft tissue and ligamentous cervical spine injury may not be fully appreciated. The goal of this pictorial review is to familiarize the reader with some of the more common soft tissue, vascular, and ligamentous injuries seen on MRI of the cervical spine in the emergent setting.

A case of combined congenital anterior and posterior arch anomaly of C1 vertebra

“…2). Although, MRI is inadequate for diagnosing because of the lack of magnetic resonance signal from cortical bones, but osseous and/ or periosseous soft tissue edema is easily visible and an important finding as indicating trauma or inflammation, thus making MRI a valuable tool for differentiating acute traumatic spinal lesions from other congenital and acquired abnormalities [9]. Furthermore, MRI study has advantages in evaluating the spinal cord, adjacent neural [1,2,5,9].…”

Omurga Acilleri

“…MRG'ye göre spinal stabilite ve tedavi şekline karar verilir [15]. Vertebra kırıkları tanısında duyarlılık; BT'de %90-100 ve MRG'de %55'tir [1].…”

“…Servikal travmada MRG endikasyonları, nörolojik semptom varlığı ve BT negatif olmasına rağmen geçmeyen boyun ağrısıdır [15]. ACR-AC; 48 saat geçmesine rağmen nörolojik değerlendirme yapılamayan olgularda, BT normal olsa bile servikal MRG önermektedir [8].…”

“…Spinal kord ödemi; T2 ağırlıklı (T2A) sekanslarda hiperintens izlenir ve aksiyel kesitte gri-beyaz cevher ayrımı kaybolur [2]. Kordda hemoraji en sık gri cevherde görülür [15]. Akut fazda deoksihemoglobine bağlı T2A ve gradient eko T2A (T2*A)'da hipointens, subakut fazda methemoglobine bağlı T1 ağırlıklı (T1A) sekansta hiperintens izlenir.…”

“…Hemoraji olmaksızın kord ödemi, iyi prognostik gösterge olup %75 olguda motor bulgular düzelir [2,16]. Kordda hemoraji geri dönüşümsüz nekroza yol açar ve kötü prognostik bulgudur [2,15,16].…”