title: Magnetic resonance imaging of severe frostbite injuries.
abstract: Frostbite injury causes damage by direct ice crystal formation at the cellular level with cellular dehydration and microvascular occlusion. Acute treatment is well defined with rapid tissue rewarming. Definitive surgical therapy is usually delayed until a clear level of demarcation is seen. Technium (Tc)-99 bone scanning has become the standard imaging study employed within the first several days to assess tissue perfusion and viability. We present 2 patients with severe frostbite injury in which magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were compared to Tc-99 bone scans. MRI/MRA appears to be superior to bone scanning by allowing direct visualization of occluded vessels, imaging of surrounding tissues, and by showing a more clear-cut line of demarcation of ischemic tissue. MRI/MRA may also allow early intervention in cases of severe frostbite, thus preventing secondary infection and increased cost.
authors.affiliation: Southern Illinois University School of Medicine, Institute for Plastic & Reconstructive Surgery, Springfield 62794-1511, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Barker
authors.forename: M J
authors.initials: MJ
authors.lastname: Haws
authors.forename: R E
authors.initials: RE
authors.lastname: Brown
authors.forename: J O
authors.initials: JO
authors.lastname: Kucan
authors.forename: W D
authors.initials: WD
authors.lastname: Moore
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D005528:Foot / Q000098:blood supply; D018409:Foot Injuries / Q000175:diagnosis / Q000601:surgery; D005627:Frostbite / Q000175:diagnosis* / Q000601:surgery; D006230:Hand Injuries / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery; D007866:Leg / Q000098:blood supply; D007869:Leg Injuries / Q000175:diagnosis / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013667:Technetium
chemical_list: D013667:Technetium