Comparison of Diagnostic Accuracy of MRI with and Without Contrast in Diagnosis of Traumatic Spinal Cord Injuries

Acute spinal cord injury (SCI) is one of the most common causes of severe disability and mortality after trauma. Magnetic resonance imaging (MRI) can identify different levels of SCI, but sometimes unable to detect the associated soft tissue injuries. The role of MRI with contrast in patients with S...

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Bibliographic Details
Published in:Medicine (Baltimore) 2015-10, Vol.94 (43), p.e1942-e1942
Main Authors: Ghasemi, Ahmad, Haddadi, Kaveh, Shad, Ali Ahmadi
Format: Article
Language:English
Subjects:
Adult
Aged
Contrast Media
Cross-Sectional Studies
Female
Humans
Magnetic Resonance Imaging - methods
Male
Meglumine
Middle Aged
OBSERVATIONAL STUDY
Organometallic Compounds
Spinal Cord Injuries - diagnosis
Young Adult
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Summary:Acute spinal cord injury (SCI) is one of the most common causes of severe disability and mortality after trauma. Magnetic resonance imaging (MRI) can identify different levels of SCI, but sometimes unable to detect the associated soft tissue injuries. The role of MRI with contrast in patients with SCI has not been studied. This is the first study in human to compare the efficacy of MRI with and without contrast in diagnosis and prognosis evaluation of SCIs.In this cross-sectional diagnostic study, MRI with and without contrast was performed on 40 patients with acute spinal injury. In these patients, 3 different types of MRI signal patterns were detected and compared.The most common cases of spinal injuries were accident (72.5%) and the after fall (27.5%). The prevalence of lesions detected includes spine fracture (70%), spinal stenosis (32.5%), soft tissue injuries (30%), and tearing of the spinal cord (2.5%). A classification was developed using 3 patterns of SCIs. Type I, seen in 2 (5.0%) of the patients, demonstrated a decreased signal intensity consistent with acute intraspinal hemorrhage. Type II, seen in 8 (20.0%) of the patients, demonstrated a bright signal intensity consistent with acute cord edema. Type III, seen in 1 (2.5%) of the patients, demonstrated a mixed signal of hypointensity centrally and hyperintensity peripherally consistent with contusion. In the diagnosis of all injuries, MRI with contrast efficacy comparable to noncontrast MRI, except in the diagnosis of soft tissue, which was significantly higher sensitivity (P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000001942