Imaging and Microscopy > Magnetic Resonance Imaging

User Ratings

Your rating: None
Your rating: None
Your rating: None
 Add your comments

Spinal Trauma

J. Randy Jinkins1,  David D. Stark1

1Downstate Medical Center, State University of New York, Brooklyn, New York

Publication Name: 
Current Protocols in Magnetic Resonance Imaging
Unit Number: 
UNIT A8.6
DOI: 
10.1002/0471142719.mia0806s05
Print Publication Date: 
June, 2002
Online Posting Date: 
August, 2002
GO TO THE FULL TEXT:
PDF or HTML at Wiley Interscience
Are you the author of this protocol? Login or register and return to this page.

Abstract

This unit presents a basic protocol for conventional and fast spin echo imaging of spine for detecting spinal trauma. MR demonstrates traumatic change quite well within the spinal cord and epidural tissues. An alternate protocol is presented based on contrast enhanced acquisitions where MRI scan that has findings that do not match the clinical findings.

     
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Interscience

Table of Contents

  • Unit Introduction
  • Basic Protocol: Conventional Fast Spin Echo and Gradient-Recalled Echo Acquisitions
  • Alternate Protocol: Contrast Enhanced Acquisitions
  • Commentary
  • Literature Cited
  • Figures
  • Tables
     
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Interscience

Materials

Alternate Protocol: Contrast Enhanced Acquisitions

 Materials
  • Normal saline (0.9% NaCl), sterile
  • Extravascular contrast agent (e.g., Magnevist, Omniscan, or Prohance)
Looking for materials?  Suppliers Guide
     
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Interscience

Figures

  • Figure A8.6.1
    Spinal cord contusion. Sagittal T2-weighted (TR = 4000 msec, TE = 100 msec) MR shows multiple areas of spinal column marrow hyperintensity indicating bony injury and hyperintensity within the cervical spinal cord (asterisk) indicating contusion.

    View Image
  • Figure A8.6.2
    Traumatic epidural intraspinal hematoma.Sagittal T1-weighted (TR = 500m sec,TE = 10 msec) image shows hyperintense epidural hematoma formation throughout the thoracolumbar area anteriorly and posteriorly (asterisks).

    View Image
  • Figure A8.6.3
    Hemorrhagic spinal cord contusion. (A) Sagittal T1-weighted (TR = 500 msec, TE = 10 msec) image shows cervical spinal cord swelling (asterisk). (B) Transverse T2*gradient-recalled echo (TR = 500 msec, TE = 15 msec, flip angle = 15°) image shows an area of focal hypointensity (arrow) indicating acute hemorrhage (deoxyhemoglobin).

    View Image
  • Figure A8.6.4
    Traumatic spinal ligamentous injury. Sagittal T2-weighted (TR = 4000 msec, TE = 100 msec) fat suppressed image shows a focal segmental dehiscence of the ligamenta flava (arrow) indicating traumatic rupture of these ligaments.

    View Image

Literature Cited

Literature Cited
    Bashir, E.F., Cybulski, G.R., Chaudhri, K., and Choudhury, A.R. 1993. Magnetic resonance imaging and computed tomography in the evaluation of penetrating gunshot injury of the spine. Spine 18:772-795.
    Curati, W.L., Kingsley, D.P.E., Kendall, B.E., and Moseley, I.F. 1992. MRI in chronic spinal cord trauma. Neuroradiology 35:30-35.
    Davis, P.C., Reisner, A., Hudgins, P.A., Davis, W.E., and O'Brien, M.S. 1993. Spinal injuries in children: Role of MR. Am. J. Neuroradiol. 14:607-717.
    Emery, S.E., Pathria, M.N., Wilber, R.G., Masaryk, T., Bohlman, H.H. 1989. MR imaging of post-traumatic spinal ligament injury. J. Spinal Disorders 2:229-233.
    Flanders, A.E., Schaefer, D.M., Doan, H.T., Mishkin, M.M., Gonzalez, C.F., and Northrup, B.E. 1990. Acute cervical spine trauma: Correlation of MRI findings with degree of neurologic deficit. Radiology 177:25-33.
    Jinkins, J.R. 1993a. MR of enhancing nerve roots in the unoperated lumbosacral spine. Am. J. Neuroradiol. 14:193-202.
    Jinkins, J.R. 1993b. Magnetic resonance imaging of benign nerve root enhancement in the unoperated and postoperative lumbosacral spine. Neuroimaging Clin. North Am. 3:525-541.
    Jinkins, J.R. 1998a. Magnetic resonance evaluation of the symptomatic patient with acute or remote spinal trauma. Part I. Direct nonpenetrating/blunt and penetrating trauma. J. Hong Kong Coll. Radiol. 1:17-26.
    Jinkins, J.R. 1998b. Magnetic resonance evaluation of the symptomatic patient with acute or remote spinal trauma. Part II. Distraction trauma. J. Hong Kong Coll. Radiol. 1:106-112.
    Jinkins, J.R. 1999. Magnetic resonance evaluation of the symptomatic patient with acute or remote spinal trauma. Part III. Indeterminate/ degenerative/acquired traumatic spinal effects. Blunt and penetrating trauma. J. Hong Kong Coll. Radiol. 2:14-20.
    Jinkins, J.R., Reddy, S., Leite, C.C., Bazan, C., III., and Xiong, L. 1998. MR of parenchymal spinal cord signal change as a sign of active advancement in clinically progressive posttraumatic syringomyelia. Am. J. Neuroradiol. 19:177-182.
    Kerslake, R.W., Jaspan, T., and Worthington, B.S. 1991. Magnetic resonance imaging of spinal trauma. Br. J. Radiol. 64:386-402.
    Kliewer, M.A., Gray, L., Paver, J., Richardson, W.D., Vogler, J.B., McElhaney, J.H., and Myers, B.S. 1993. Acute spinal ligament disruption: MR imaging with anatomic correlation. J. Magn. Reson. Imaging 3:855-861.
    Leite, C.C., Escobar, B.E., Bazan, C., III., and Jinkins, J.R. 1997. MR imaging of cervical facet dislocation. Neuroradiology 39:583-588.
    Mathis, J.M., Wilson, J.T., Barnard, J.W., and Zelenik, M.E. 1988. MR imaging of spinal cord avulsion. Am. J. Neuroradiol. 9:1232-1233.
    Mayer, J.S. and Kulkarni, M.V. 1987. MR imaging of incisional spinal cord injury. Am. J. Neuroradiol. 8:925-927.
    Mendolsohn, D.B., Zollars, L., Weatherall, P.T., and Girson, M. 1990. MR of cord transection. J. Comput. Assist. Tomogr. 14:909-911.
    Mirvis, S.E., Geisler, F.H., Jelinek, J.J., Joslyn, J.N., and Gellad, F. 1988. Acute cervical spine trauma: Evaluation with 1.5 T MRI. Radiology ] 166:807-816.
    Pan, G., Kulkarni, M., MacDougall, D.J., and Miner, M.E. 1988. Traumatic epidural hematoma of the cervical spine. Diagnosis with magnetic resonance imaging. J. Neurosurg. 68:798-801.
    Post, M.J., Becerra, J.L., Madsen, P.W., Puckett, W., Quencer, R.M., Bunge, R.P., and Sklar, E.M. 1994. Acute spinal subdural hematoma: MR imaging and CT findings with pathologic correlates. Am. J. Neuroradiol. 15:1895-1905.
    Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott-Raven, Philadelphia.
    Silberstein, M., Tress, B.M., and Hennessy, O. 1992. Delayed neurologic deterioration in the patient with spinal trauma: Role of MR imaging. Am. J. Nuroradiol. 13:1373-1381.
    Takahashi, M., Sakamoto, Y., Miyawaki, M., and Bussaka, H. 1987. Increased MR signal intensity secondary to chronic cervical cord compression. Neuroradiology 29:550-556.
     
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Interscience
Looking for Answers?
Do you have tips, tricks, or improvements to share?

Join the Conversation

Post new comment

The content of this field is kept private and will not be shown publicly.
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.