Magnetic resonance imaging in acute traumatic injuries of ligaments and soft tissues of cervical spine in children

Abstract

Aim of the study: to study the role and possibilities of magnetic resonance imaging (MRI) in the diagnosis of injuries of ligaments and soft tissues of the cervical spine in emergency care. Materials and methods. MRI was performed in fifty two children with trauma of the cervical spine, in 1 of them with contrast enhancement. Boys predominated - 33 (63.5%), girls were 19 (36.5%). The age of the patients varied from 3 to 17 years, the mean age was 14 ± 1.4 years. The study was carried out on a Phillips Achieva dStream 3T scanner. The study protocol includes MR-myelography in sagittal and coronary projections, T2WI sagittal projection in PS STIR, T2WI SE, T1WI SE, DTI, axial projection of T2WI SE or T2*WI GRE. Results. Trauma of cervical spine was combined in 46% (n = 24) of all 52 cases, and in 54% (n = 28) it was isolated. During the clinical and neurological examination according to the ASIA impairment scale, there were 13 (25%) children with grade A, 3 (5.8%) with grade B, 9 (17.3%) with grade C, 4 (7.7%) with degree D and 23 (44.2%) with grade E. Spinal cord injuries in the form of hematomyelia were detected in 13 (25%) children, contusion and swelling of the spinal cord - in 15 children (29%). According to MRI results, 4 (7.7%) had a traumatic hernia with a decrease in disc height, 15 (28.8%) had secondary stenosis of the spinal canal at the time of the study, 28 (53.8%) had spinal cord compression and changes in the MR signal, 5 (9.6%) had epi- and subdural hematomas, 45 (86.5%) had vertebral fractures. Conclusion. MRI, as a method more sensitive than other imaging modalities in the diagnosis of soft tissue and spinal cord injuries, allows radiologist directly assessing the condition of spine soft tissues and, therefore, is critical in the evaluation of a patient with ligament injury and instability. Recognition of soft tissue injuries affects patient management and outcome.