Magnetic resonance imaging of ligaments and membranes in the craniocervical junction in whiplash-associated injury and in healthy control subjects.
BACKGROUND
The pathogenesis and imaging findings in whiplash-associated injury (WAD) are poorly understood and remain debatable.


OBJECTIVE
To assess the ligaments and membranes in the craniocervical junction with magnetic resonance imaging (MRI) in patients with WAD and to compare them with healthy control subjects.


METHODS
Twenty-eight patients with WAD were selected at random from a total number of 180 examined with MRI using 2-mm proton density (PD)-weighted images in three orthogonal planes at 1.5T. The patients were compared with 27 healthy control subjects without neck trauma.


RESULTS
High signal intensity of the alar and transverse ligaments was quite common and was reported at an average of about 50% both among patients and control subjects. The incidence of abnormalities of the tectorial and posterior atlantooccipital membranes was low in both groups. No statistically significant difference between control subjects and patients with WAD was revealed for any of the structures assessed. Additional fat-suppressed images seemed to reduce the number of reported anomalies.


CONCLUSIONS
Due to lack of significant differences between patients with WAD and healthy control subjects, it is not recommended that MRI with the current technique and classification system be used in the routine workup of patients with WAD.
Dullerud
Reidar
R
Department of Neuroradiology, Ullevål University Hospital, Oslo, Norway. redu@lds.no
Gjertsen
Oivind
O
Server
Andrés
A
D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000293:injuries*; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000293:injuries*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D014911:Whiplash Injuries / Q000473:pathology*