CT, MR imaging and muscle biopsy in severe crush injury

Purpose: We reviewed CT and MR findings in crush injuries in muscles and compared them with findings at muscle biopsy. Material and Methods: CT and MR examinations were made of the lower extremities in 6 adult patients whose muscles were crushed in the big earthquake in Kobe, Japan, on 17 January 1995. All CT examinations were performed twice and within 60 days of the earthquake. In 5 of the 6 patients, biopsies were taken of the injured muscle after the CT and MR examinations. Results: At CT investigation, the images in 5 patients showed calcification in the muscles, and the crushed muscle appeared atrophic. In 3 of these 5, the degree of calcification decreased with time. At MR investigation, T1-weighted images of the crushed muscle showed isointensity in 4 of the 6 patients and high intensity in the remaining 2. T2-weighted images of the crushed muscle showed inhomogeneous high intensity in all patients. After Gd injection, all the crushed muscles were enhanced, either slightly or markedly. At muscle biospy, in 5 of the 6 cases, the findings showed calcification in the muscle cells and the total destruction of the normal muscle structure. Conclusion: CT and MR findings in crush injury correlated well with the findings at histopathology.