Labattaglia Matthew P, Cameron Peter A, Santamaria Mark, Varma Dinesh, Thomson Kevin, Bailey Michael, Kossmann Thomas
Emergency and Trauma Centre, Alfred Hospital, Melbourne, Australia.
Emerg Med Australas. 2007 Jun;19(3):253-61. doi: 10.1111/j.1742-6723.2007.00960.x.
To determine whether MRI of the cervical spine resulted in a change in management of patients with blunt trauma and normal plain X-ray (XR)/CT of the cervical spine.
An explicit chart review was conducted of patients seen at a Level 1 trauma centre over a 1 year period. Clinical details were extracted from the charts of patients with blunt trauma who had a normal plain XR and CT scan of the cervical spine and who underwent cervical spine MRI. A comparison of clinical details was made between those with a normal/abnormal MRI secondary to the acute injury.
One hundred and thirty-four patients met entry criteria. Discharge non-operative management of the cervical spine was associated with a change in management by the MRI result (P < 0.0001) where MRI of the cervical spine occurred a median of 3 days (interquartile range 0-4.5, range 0-137) after the injury. The MRI occurred before discharge 90% of the time in both groups. Operative management occurred in three patients and was delayed until after first outpatient review in two patients.
An abnormal MRI after normal plain XR and CT cervical spine studies resulted in a change in non-operative management at discharge. Early MRI resulted in one patient receiving surgery before discharge. No unstable injuries were detected by MRI that were not evident on plain XR or CT cervical spine.
确定颈椎磁共振成像（MRI）是否会改变颈椎钝性创伤且X线平片（XR）/CT正常的患者的治疗方案。
对一家一级创伤中心1年内诊治的患者进行明确的病历回顾。从颈椎钝性创伤患者的病历中提取临床细节，这些患者颈椎X线平片和CT扫描正常且接受了颈椎MRI检查。对急性损伤后MRI正常/异常的患者的临床细节进行比较。
134例患者符合纳入标准。颈椎的出院非手术治疗与MRI结果导致的治疗方案改变相关（P<0.0001），颈椎MRI在受伤后中位时间为3天（四分位间距0 - 4.5，范围0 - 137）进行。两组中90%的MRI在出院前进行。3例患者接受了手术治疗，2例患者的手术延迟至首次门诊复查之后。
颈椎X线平片和CT检查正常后MRI异常导致出院时非手术治疗方案改变。早期MRI使1例患者在出院前接受了手术。MRI未检测到颈椎X线平片或CT上不明显的不稳定损伤。
