Magnetic resonance imaging of spinal trauma at acute and early stage
Keywords:spinal injury, magnetic resonance imaging, edema
The topic actuality is conditioned upon the necessity to optimize the diagnostic detection in patients with spinal injury, imaging of spinal medulla damage, secondary alterations with the help of MRI examination. Standard magnetic resonance imaging examination of the patients was performed to diagnose the prevalence rate of ischemia and edema. According to previously published studies, the main factors in the pathogenesis of spinal cord injury are attributed to primary and secondary mechanism. Primary spinal cord injury occurs at the time of the initial trauma or damage, forming a zone of spinal cord contusion. Disorders can be found in the local vasculature, causing edema and hemorrhage. Paralysis of motor, sensory and autonomic neuronal functions can occur in the damaged area. Vascular dysfunction, ischemia, glutamatergic excitotoxicity, inflammation and apoptosis also develop in the perifocal zone.
Methods. There was carried out standard MRI examination of the affected region of vertebral column in 24 patients, 11 patients of which has trauma in cervical area and 13 – in thoracic part. The examination was carried out within the term from 1 to 18 days, in the modes Т1 and Т2 WI in IS SE. To standardize the study there was defined extension of edema or signal change in the medullary substance, level of spinal medulla compression.
Results. The study is carried out on the following day after trauma and it is defined the site of injury, hemorrhachis and medullary substance edema site in the area of initial injury within the measures of 1-2 segments of spinal medulla. MRI of 2-13 days shows increased distribution of hemorrhachis and medullary substance edema within 4-5 segments of spinal medulla, evidencing globalization of secondary alteration of spinal medulla.
Conclusions. Magnetic resonance imaging is the leading method in the diagnosis of swelling of the spinal cord injury and hemorrhage. Secondary changes in the spinal cord are revealed during the study. The method allows visualizing the extent and severity of damage to the spinal cord, hence the importance of the method in the initial phase of treatment, patients with spinal cord injury
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