TY - JOUR
T1 - Acute cervical spine injuries
T2 - Prospective MR imaging assessment at a level 1 trauma center
AU - Katzberg, Richard W.
AU - Benedetti, Philip F.
AU - Drake, Christiana M.
AU - Ivanovic, Marija
AU - Levine, Richard A.
AU - Beatty, Carol S.
AU - Nemzek, William R.
AU - McFall, Russell A.
AU - Ontell, Francesca K.
AU - Bishop, Dorene M.
AU - Poirier, Virginia C.
AU - Chong, Brian W.
PY - 1999/10
Y1 - 1999/10
N2 - PURPOSE: To determine the weighted average sensitivity of magnetic resonance (MR) imaging in the prospective detection of acute neck injury and to compare these findings with those of a comprehensive conventional radiographic assessment. MATERIALS AND METHODS: Conventional radiography and MR imaging were performed in 199 patients presenting to a level 1 trauma center with suspected cervical spine injury. Weighted sensitivities and specificities were calculated, and a weighted average across eight vertebral levels from C1 to T1 was formed. Fourteen parameters indicative of acute injury were tabulated. RESULTS: Fifty-eight patients had 172 acute cervical injuries. MR imaging depicted 136 (79%) acute abnormalities and conventional radiography depicted 39 (23%). For assessment of acute fractures, MR images (weighted average sensitivity, 43%; CI: 21%, 66%) were comparable to conventional radiographs (weighted average sensitivity, 48%; CI: 30%, 65%). MR imaging was superior to conventional radiography in the evaluation of pre- or paravertebral hemorrhage or edema, anterior or posterior longitudinal ligament injury, traumatic disk herniation, cord edema, and cord compression. Cord injuries were associated with cervical spine spondylosis (P < .05), acute fracture (P < .001), and canal stenosis (P < .001). CONCLUSION: 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.
AB - PURPOSE: To determine the weighted average sensitivity of magnetic resonance (MR) imaging in the prospective detection of acute neck injury and to compare these findings with those of a comprehensive conventional radiographic assessment. MATERIALS AND METHODS: Conventional radiography and MR imaging were performed in 199 patients presenting to a level 1 trauma center with suspected cervical spine injury. Weighted sensitivities and specificities were calculated, and a weighted average across eight vertebral levels from C1 to T1 was formed. Fourteen parameters indicative of acute injury were tabulated. RESULTS: Fifty-eight patients had 172 acute cervical injuries. MR imaging depicted 136 (79%) acute abnormalities and conventional radiography depicted 39 (23%). For assessment of acute fractures, MR images (weighted average sensitivity, 43%; CI: 21%, 66%) were comparable to conventional radiographs (weighted average sensitivity, 48%; CI: 30%, 65%). MR imaging was superior to conventional radiography in the evaluation of pre- or paravertebral hemorrhage or edema, anterior or posterior longitudinal ligament injury, traumatic disk herniation, cord edema, and cord compression. Cord injuries were associated with cervical spine spondylosis (P < .05), acute fracture (P < .001), and canal stenosis (P < .001). CONCLUSION: 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.
KW - Magnetic resonance (MR), comparative studies
KW - Spinal cord, injuries
KW - Spine, CT
KW - Spine, MR
KW - Spine, injuries
KW - Spine, radiography
KW - Trauma
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U2 - 10.1148/radiology.213.1.r99oc40203
DO - 10.1148/radiology.213.1.r99oc40203
M3 - Article
C2 - 10540663
AN - SCOPUS:0032886448
SN - 0033-8419
VL - 213
SP - 203
EP - 212
JO - Radiology
JF - Radiology
IS - 1
ER -