Acute cervical spine injuries: prospective MR imaging assessment at a level 1 trauma center

Radiology. 1999 Oct;213(1):203-12. doi: 10.1148/radiology.213.1.r99oc40203.


Purpose: 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.

Materials and 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).

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / injuries*
  • Cervical Vertebrae / pathology
  • Child
  • Female
  • Hemorrhage / diagnosis
  • Hemorrhage / diagnostic imaging
  • Humans
  • Intervertebral Disc Displacement / diagnosis
  • Intervertebral Disc Displacement / diagnostic imaging
  • Joint Dislocations / diagnosis
  • Joint Dislocations / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Spinal Fractures / diagnosis
  • Spinal Fractures / diagnostic imaging
  • Spinal Injuries / diagnosis
  • Spinal Injuries / diagnostic imaging
  • Tomography, X-Ray Computed