Wong C S, Chu Y C T, Ma K F J, Cheng L F
Department of Radiology, Princess Margaret Hospital, Mei Foo, Hong Kong.
Singapore Med J. 2009 Sep;50(9):894-6.
Spinal cord compression is a very debilitating condition and could be secondary to many causes. Urgent magnetic resonance (MR) imaging of the spine is crucial in making the diagnosis and guiding further management. Our objectives were to assess the nature of MR imaging requests, the diagnostic yield, and the subsequent management according to relevant MR imaging findings.
We focused on all the urgent MR imagings of the spine conducted from July 1, 2007 to December 31, 2007. Clinical data, including the demographical information, presenting symptoms, radiological diagnosis, waiting time for MR imaging and treatment, was reviewed.
A total of 33 cases of urgent MR imaging of the spine were performed. Patients were aged 29-85 years, with 18 males and 15 females. Most of them (84.8 percent) presented with neurological symptoms. 84 percent of the MR imaging was performed within 24 hours. 76 percent of the examinations yielded significant cord compression, of which 56 percent were due to vertebral metastasis, while others were due to epidural haematoma (12 percent), infective spondylodiscitis (8 percent), vertebral fracture (8 percent) and disc herniation (16 percent). Of the vertebral metastasis patients, 43 percent had one region imaged. 64 percent of the cord compression patients received surgical treatment or radiotherapy, with a mean waiting time of 1.7 days.
The urgent MR imaging spine service was able to react promptly with a high diagnostic yield. One-third of the patients with vertebral metastasis had multiple levels involved, and imaging of the whole spine would be useful.
脊髓压迫是一种非常使人衰弱的病症，可能继发于多种原因。脊柱的紧急磁共振（MR）成像对于做出诊断和指导进一步治疗至关重要。我们的目的是根据相关MR成像结果评估MR成像请求的性质、诊断率以及后续治疗。
我们关注了2007年7月1日至2007年12月31日期间进行的所有脊柱紧急MR成像。回顾了临床数据，包括人口统计学信息、出现的症状、放射学诊断、MR成像和治疗的等待时间。
共进行了33例脊柱紧急MR成像。患者年龄在29 - 85岁之间，男性18例，女性15例。他们中的大多数（84.8%）出现神经症状。84%的MR成像在24小时内完成。76%的检查显示有明显的脊髓压迫，其中56%是由于椎体转移，其他原因包括硬膜外血肿（12%）、感染性脊椎椎间盘炎（8%）、椎体骨折（8%）和椎间盘突出（16%）。在椎体转移患者中，43%对一个部位进行了成像。64%的脊髓压迫患者接受了手术治疗或放疗，平均等待时间为1.7天。
脊柱紧急MR成像服务能够迅速做出反应，诊断率高。三分之一的椎体转移患者有多个节段受累，对整个脊柱进行成像会很有用。
