对于经体格检查不能排除颈椎损伤的患者，在颈椎CT扫描结果正常后进行颈椎MRI筛查。
Screening cervical spine MRI after normal cervical spine CT scans in patients in whom cervical spine injury cannot be excluded by physical examination.
作者信息
Steigelman Megan, Lopez Peter, Dent Daniel, Myers John, Corneille Michael, Stewart Ronald, Cohn Stephen
机构信息
Division of Trauma, University of Texas, Health Sciences Center, San Antonio, TX, USA.
出版信息
Am J Surg. 2008 Dec;196(6):857-62; discussion 862-3. doi: 10.1016/j.amjsurg.2008.07.040.
BACKGROUND
Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury.
METHODS
A retrospective review was conducted of trauma patients admitted to a level I trauma center from 2002 to 2006, in whom cervical spine injuries could not be excluded by physical examination. All patients with normal results on cervical spine CT followed by cervical spine MRI were included in the analysis.
RESULTS
One hundred twenty patients underwent MRI to examine their cervical spines. Seven patients had abnormal MRI findings suggestive of acute traumatic injury. No MRI studies led to operative intervention. Screening MRI increased from 1% of comatose patients in 2002 to 18% in 2006.
CONCLUSIONS
The use of MRI in patients with normal results on cervical spine CT does not appear to alter treatment.
背景
在因闭合性颅脑损伤导致精神状态改变的钝性创伤患者中，多达10%会发生颈椎损伤。尽管颈椎计算机断层扫描（CT）结果正常，但通常仍建议进行磁共振成像（MRI）以排除韧带或软组织损伤。
方法
对2002年至2006年入住一级创伤中心的创伤患者进行回顾性研究，这些患者经体格检查不能排除颈椎损伤。所有颈椎CT结果正常且随后进行颈椎MRI检查的患者均纳入分析。
结果
120例患者接受了颈椎MRI检查。7例患者MRI检查结果异常，提示急性创伤性损伤。没有MRI检查导致手术干预。筛查性MRI在2002年占昏迷患者的1%，到2006年增至18%。
结论
颈椎CT结果正常的患者使用MRI似乎不会改变治疗方案。
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