title: Acute cervical spine injuries: prospective MR imaging assessment at a level 1 trauma center.
abstract: 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.
authors.affiliation: Department of Radiology, University of California-Davis Medical Center, Sacramento 95817, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Katzberg
authors.forename: P F
authors.initials: PF
authors.lastname: Benedetti
authors.forename: C M
authors.initials: CM
authors.lastname: Drake
authors.forename: M
authors.initials: M
authors.lastname: Ivanovic
authors.forename: R A
authors.initials: RA
authors.lastname: Levine
authors.forename: C S
authors.initials: CS
authors.lastname: Beatty
authors.forename: W R
authors.initials: WR
authors.lastname: Nemzek
authors.forename: R A
authors.initials: RA
authors.lastname: McFall
authors.forename: F K
authors.initials: FK
authors.lastname: Ontell
authors.forename: D M
authors.initials: DM
authors.lastname: Bishop
authors.forename: V C
authors.initials: VC
authors.lastname: Poirier
authors.forename: B W
authors.initials: BW
authors.lastname: Chong
mesh_terms: 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