Acute cervical spine injuries: prospective MR imaging assessment at a level 1 trauma center.
OBJECTIVE
To determine the weighted average sensitivity of magnetic resonance (MR) imaging in the prospective detection of acute neck injury and to compare these findings with those of a comprehensive conventional radiographic assessment.


METHODS
Conventional radiography and MR imaging were performed in 199 patients presenting to a level 1 trauma center with suspected cervical spine injury. Weighted sensitivities and specificities were calculated, and a weighted average across eight vertebral levels from C1 to T1 was formed. Fourteen parameters indicative of acute injury were tabulated.


RESULTS
Fifty-eight patients had 172 acute cervical injuries. MR imaging depicted 136 (79%) acute abnormalities and conventional radiography depicted 39 (23%). For assessment of acute fractures, MR images (weighted average sensitivity, 43%; CI: 21%, 66%) were comparable to conventional radiographs (weighted average sensitivity, 48%; CI: 30%, 65%). MR imaging was superior to conventional radiography in the evaluation of pre- or paravertebral hemorrhage or edema, anterior or posterior longitudinal ligament injury, traumatic disk herniation, cord edema, and cord compression. Cord injuries were associated with cervical spine spondylosis (P < .05), acute fracture (P < .001), and canal stenosis (P < .001).


CONCLUSIONS
MR imaging is more accurate than radiography in the detection of a wide spectrum of neck injuries, and further study is warranted of its potential effect on medical decision making, clinical outcome, and cost-effectiveness.
Katzberg
R W
RW
Department of Radiology, University of California-Davis Medical Center, Sacramento 95817, USA.
Benedetti
P F
PF
Drake
C M
CM
Ivanovic
M
M
Levine
R A
RA
Beatty
C S
CS
Nemzek
W R
WR
McFall
R A
RA
Ontell
F K
FK
Bishop
D M
DM
Poirier
V C
VC
Chong
B W
BW
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D002648:Child; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000000981:diagnostic imaging; D004204:Joint Dislocations / Q000175:diagnosis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging; D013124:Spinal Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed