Is magnetic resonance imaging becoming the new computed tomography for cervical spine clearance? Trends in magnetic resonance imaging utilization at a Level I trauma center

2020 ◽  
Vol 89 (2) ◽  
pp. 365-370
Author(s):  
Raymond Huang ◽  
Robert C. Ryu ◽  
Terrence T. Kim ◽  
Rodrigo F. Alban ◽  
Daniel R. Margulies ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Trauma Center ◽  
Resonance Imaging ◽  
Imaging Utilization ◽  
Level I

Trauma Imaging

2020 ◽  
Author(s):  
Joel A. Gross ◽  
Martin L. Gunn ◽  
Kathleen R. Fink
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Penetrating Trauma ◽  
Organ Injury ◽  
Bladder Rupture ◽  
Subdural Hemorrhage ◽  
Solid Organ ◽  
Resonance Imaging

Due to increased use of computed tomography (CT) and ultrasonography, technological advances in equipment design, and increased availability of imaging equipment in the emergency department, imaging studies have revolutionized the assessment of the trauma patient in the past three decades. This review examines commonly used imaging modalities in trauma evaluation, initial and additional imaging, brief introduction to CT, and an overview of CT image processing and reviewing a CT scan. Head imaging, spine imaging, chest imaging, and abdominal and pelvic imaging are presented, along with injury grading, solid-organ injury appearances and specific abdominal solid-organ injuries, urinary system injury, penetrating trauma, unexplained intraperitoneal fluid, vascular injury and musculoskeletal injury. Figures show lateral view of the cervical spine; volume rendering of the pelvis; CT windows; CT imaging of acute intracranial bleeding, herniation in acute subdural hemorrhage, post-traumatic pseudoaneurysm of descending thoracic aorta, subscapular hematoma of the liver, liver laceration, pseudoaneurysm of the liver, shattered kidney and the nonperfused right kidney attributable to a traumatic renal artery injury, tigroid spleen, a focus of gas and stranding adjacent to the lateral wall of the ascending colon, extravasated urinary contrast (white material) surrounding the proximal right indicating ureteral laceration or transection, intraperitoneal bladder rupture, and contrast extravasation in the liver; magnetic resonance imaging versus CT of shear injuries; and magnetic resonance imaging in the setting of cervical spine trauma.  This review contains 18 highly rendered figures, 23 tables, and 83 references. Keywords:Trauma, computed tomography, radiography, magnetic resonance imaging, ultrasonography, imaging study

Comparison of Magnetic Resonance Imaging and Computed Tomography in Predicting Facet Arthrosis in the Cervical Spine

Spine ◽  
2009 ◽  
Vol 34 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Ronald A. Lehman ◽  
Melvin D. Helgeson ◽  
Kathryn A. Keeler ◽  
Torphong Bunmaprasert ◽  
K Daniel Riew
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Resonance Imaging

Ulus Travma Acil Cerrahi Derg. Baskıdaki Makaleler: UTD-35813 | DOI: 10.14744/tjtes.2019.35813 Anstabil servikal yaralanmalarda Bilgisayarlı Tomografi ve Magnetik Rezonans Görüntüleme Bulgularının Karşılaştırılması Meltem Songur Kodik1, Cenk Eraslan2, Omer Kitis2, Yusuf Ali Altunci1, Huseyin Biceroglu3, Ali Akay4 1Ege Üniversitesi Tıp Fakültesi Hastanesi, Acil Tıp Anabilim Dalı, İzmir 2Ege Üniversitesi Tıp Fakültesi Hastanesi, Radyoloji Anabilim Dalı, İzmir 3Ege Üniversitesi Tıp Fakültesi Hastanesi, Beyin Cerrahisi Anabilim Dalı, İzmir 4Kent Hastanesi, Beyin Cerrahisi Bölümü, İzmir Amaç: Bu çalışmanın amacı atlanabilen anstabil servikal yaralanmaların belirlenmesinde bilgisayarlı tomografinin (BT) rolünü araştırmaktır. Yöntem: Bu çalışmada acil servise Haziran 2014 ile Haziran 2018 arasında künt servikal travma tanısı ile başvuran olgular yer almaktadır. Tüm olgular ilk önce yapılan bir BT tetkikini takiben servikal manyetik rezonans (MR) görüntülemesine tabi tutulmuşlardır. Tüm görüntüleme sonuçları gözden geçirilmiş ve kararlar acil tıp uzmanı, nöroradyolojist ve beyin cerrahından oluşan bir ekip tarafından fikir birliği ile alınmıştır. Diğer değişkenler arasında yaş, cinsiyet, Glasgow koma skalası, ek morbidite, çoklu travma, nörolojik defisitler, intrakraniyal hemoraji, ekstremite fraktürleri ve yaralanmanın mekanizması yer almaktadır. Bulgular: Çalışmaya alınan 195 hastanın bilgileri analiz edildiğinde; hastaların ortalama yaşı (±standart sapma) 47,34 ± 21,90 yıl olup 140’ ı erkek (%71,8) 18’ i (% 9,2) 18 yaşın altında idi. En sık görülen yaralanma mekanizması yüksekten düşme idi ( n=100; %51,3). Altın standart olarak MR kullanılmış olup, anstabil servikal travma tanısında BT’ nin duyarlılığı %77,7 (% 95 GA [67,1-86,1]) iken, özgüllüğü % 100,0 (%95 GA [59,0-100,0]) saptanmıştır. Sonuç: Her ne kadar bilgisayarlı tomografi anstabil servikal yaralanmaların tanısında rölatif olarak iyi olsa da duyarlılığı yeterli değildir. Bundan dolayı anstabil yaralanması olan olgularda MR çekilmesi daha uygundur. Anahtar Kelimeler: Servikal Vertebra, Boyun Yaralanmaları, Magnetik Rezonans Görüntüleme, Bilgisayarlı Tomografi, Sensivite ve Spesifite Computed Tomography vs. Magnetic Resonance Imaging in Unstable Cervical Spine Injuries

2019 ◽  
Author(s):  
Meltem Songur Kodik
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Unstable Cervical Spine

The Current Role of Magnetic Resonance Imaging for Diagnosing Cervical Spine Injury in Blunt Trauma Patients with Negative Computed Tomography Scan

2012 ◽  
Vol 78 (10) ◽  
pp. 1156-1160 ◽  
Author(s):  
Meghann L. Kaiser ◽  
Matthew D. Whealon ◽  
Cristobal Barrios ◽  
Allen P. Kong ◽  
Michael E. Lekawa ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Blunt Trauma ◽  
Multidetector Ct ◽  
Spine Injury ◽  
Trauma Patients ◽  
Resonance Imaging ◽  
Mri Findings

Clearance of cervical spine (CS) precautions in the neurologically altered blunt trauma patient can be difficult. Physical examination is not reliable, and although computed tomography (CT) may reveal no evidence of fracture, it is generally believed to be an inferior modality for assessing ligamentous and cord injuries. However, magnetic resonance imaging (MRI) is expensive and may be risky in critically ill patients. Conversely, prolonged rigid collar use is associated with pressure ulceration and other complications. Multidetector CT raises the possibility of clearing CS on the basis of CT alone. We performed a retrospective review at our Level I trauma center of all blunt trauma patients with Glasgow Coma Scale Score 14 or less who underwent both CT and MRI CS with negative CT. One hundred fourteen patients met inclusion criteria, of which 23 had MRI findings. Seven (6%) of these had neurologic deficits and/or a change in management on the basis of MRI findings. Although use of the single-slice scanner was significantly associated with MRI findings (odds ratio, 2.62; P = 0.023), no significant clinical risk factors were identified. Patients with MRI findings were heterogeneous in terms of age, mechanism, and Injury Severity Score. We conclude that CS MRI continues play a vital role in the workup of neurologically altered patients.

Trauma Imaging

2020 ◽  
Author(s):  
Joel A. Gross ◽  
Martin L. Gunn ◽  
Kathleen R. Fink
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Penetrating Trauma ◽  
Organ Injury ◽  
Bladder Rupture ◽  
Subdural Hemorrhage ◽  
Solid Organ ◽  
Resonance Imaging

Due to increased use of computed tomography (CT) and ultrasonography, technological advances in equipment design, and increased availability of imaging equipment in the emergency department, imaging studies have revolutionized the assessment of the trauma patient in the past three decades. This review examines commonly used imaging modalities in trauma evaluation, initial and additional imaging, brief introduction to CT, and an overview of CT image processing and reviewing a CT scan. Head imaging, spine imaging, chest imaging, and abdominal and pelvic imaging are presented, along with injury grading, solid-organ injury appearances and specific abdominal solid-organ injuries, urinary system injury, penetrating trauma, unexplained intraperitoneal fluid, vascular injury and musculoskeletal injury. Figures show lateral view of the cervical spine; volume rendering of the pelvis; CT windows; CT imaging of acute intracranial bleeding, herniation in acute subdural hemorrhage, post-traumatic pseudoaneurysm of descending thoracic aorta, subscapular hematoma of the liver, liver laceration, pseudoaneurysm of the liver, shattered kidney and the nonperfused right kidney attributable to a traumatic renal artery injury, tigroid spleen, a focus of gas and stranding adjacent to the lateral wall of the ascending colon, extravasated urinary contrast (white material) surrounding the proximal right indicating ureteral laceration or transection, intraperitoneal bladder rupture, and contrast extravasation in the liver; magnetic resonance imaging versus CT of shear injuries; and magnetic resonance imaging in the setting of cervical spine trauma.  This review contains 18 highly rendered figures, 23 tables, and 83 references. Keywords:Trauma, computed tomography, radiography, magnetic resonance imaging, ultrasonography, imaging study

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