Mirvis S E, Shanmuganathan K
Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore 21201, USA.
J Intensive Care Med. 1995 Jan-Feb;10(1):15-33. doi: 10.1177/088506669501000104.
Cervical spine injury constitutes a major cause of morbidity resulting from trauma. The consequences of a missed "significant" injury can be devastating for the patient and can create potential medical legal consequences for involved physicians. Multiple imaging modalities can be applied to imaging of the cervical spine after trauma, including radiography, computed tomography (CT), myelography, CT myelography and magnetic resonance imaging (MRI). Controversy exists concerning the appropriate number of radiographic views required for the screening assessment of cervical spine injuries. CT clarifies uncertain radiological findings, identifies subtle fractures in patients with neck pain or with neurological deficits but with normal radiographs, determines details of injury, and assists in operative planning. MRI has virtually replaced myelography and CT myelography in evaluating the traumatized cervical spine. MRI is more accurate than CT with intrathecal contrast in delineating epidural pathology, ligament injury, soft-tissue edema, and cord parenchymal injury. Information derived from MRI guides appropriate management and has value in predicting injury outcome. We consider indications for and relative merits of these various diagnostic modalities, and we describe imaging features of major patterns of cervical spine injury.
颈椎损伤是创伤导致发病的主要原因。漏诊“严重”损伤的后果对患者可能是灾难性的，并且可能给相关医生带来潜在的医疗法律后果。多种成像方式可用于创伤后颈椎的成像，包括X线摄影、计算机断层扫描（CT）、脊髓造影、CT脊髓造影和磁共振成像（MRI）。关于颈椎损伤筛查评估所需的适当X线片数量存在争议。CT可明确不确定的放射学表现，识别颈部疼痛或有神经功能缺损但X线片正常的患者的细微骨折，确定损伤细节，并协助手术规划。在评估创伤后的颈椎时，MRI实际上已取代了脊髓造影和CT脊髓造影。在描绘硬膜外病变、韧带损伤、软组织水肿和脊髓实质损伤方面，MRI比增强CT更准确。从MRI获得的信息指导适当的治疗，并在预测损伤结果方面具有价值。我们考虑这些各种诊断方式的适应证和相对优点，并描述颈椎损伤主要类型的影像学特征。
