Boruah Deb K, Hazarika Karuna, Borah Krishna K, Ahmed Halimuddin, Sharma Barun K
Radiodiagnosis, Tezpur Medical College, Tezpur, IND.
Radiodiagnosis, Sikkim Manipal Institute of Medical Science, Gangtok, IND.
Cureus. 2021 Apr 26;13(4):e14694. doi: 10.7759/cureus.14694.
Background Multiecho fast field echo (mFFE) MRI sequence provides added value to the conventional MR imaging in evaluation of acute spinal trauma, especially for detecting spinal cord hemorrhage which is a best predictor for patient prognosis. Objective This study aims to evaluate the diagnostic efficacies of three-plane mFFE MRI sequence along with the conventional MRI sequences in acute spinal trauma patients using sensitivity. Materials and methods This prospective study comprised of 48 patients of acute spinal trauma. The neurological deficit of acute spinal trauma patients assessed according to the American Spine Injury Association (ASIA) scale. The correlation between the various MRI findings of acute spinal cord injury and neurological deficits were compared with the Chi-square test. Results Of 48 patients of acute spinal trauma, 36 males and 12 females with a mean age of 38.71±1.42 [SD] years. 22 (45.8%) patients had cord edema with a mean length of was 3.45±5.52 [SD] cm. The mean percentage of spinal canal compromisation was 39.47±25.47 [SD] and spinal cord compression 18.1±24.4 [SD]. There was statistical significance between the ASIA impairment scale and spinal canal compromisation and cord compression with a p-value of 0.0005. Cord hemorrhage observed in 13 (27%), non-hemorrhagic cord contusions in 3 (6.3%), cord transection in 5 (10.4%) and epidural hematoma in 10 (20.8%) patients with an initial high grade of ASIA scale. The visibility score of three-plane mFFE sequence was higher in comparison to the single plane sagittal mFFE and short tau inversion recovery (STIR) sequences. For detection of spinal cord hemorrhage with visibility score of 2, the three-plane mFFE had sensitivity of 77% followed by 38.5% with single plane sagittal mFFE and 7.7% with sagittal STIR images. 26 (54.2%) patients showed neurological improvement in their hospital stay/follow-up period and no improvement observed in 7 (14.6%) patients of acute spinal trauma. Conclusions Application of three-plane mFFE sequences detects more spinal cord hemorrhages and vertebral fractures with a better visibility score as compared to the single sagittal plane mFFE and STIR sequence.
背景 多回波快速场回波（mFFE）MRI序列在评估急性脊柱创伤方面为传统MR成像提供了附加价值，尤其是在检测脊髓出血方面，脊髓出血是患者预后的最佳预测指标。目的 本研究旨在使用敏感性评估三平面mFFE MRI序列与传统MRI序列在急性脊柱创伤患者中的诊断效能。材料与方法 这项前瞻性研究纳入了48例急性脊柱创伤患者。根据美国脊柱损伤协会（ASIA）量表评估急性脊柱创伤患者的神经功能缺损。采用卡方检验比较急性脊髓损伤的各种MRI表现与神经功能缺损之间的相关性。结果 在48例急性脊柱创伤患者中，男性36例，女性12例，平均年龄为38.71±1.42[标准差]岁。22例（45.8%）患者出现脊髓水肿，平均长度为3.45±5.52[标准差]cm。椎管狭窄的平均百分比为39.47±25.47[标准差]，脊髓受压为18.1±24.4[标准差]。ASIA损伤量表与椎管狭窄和脊髓受压之间存在统计学意义，p值为0.0005。13例（27%）患者观察到脊髓出血，3例（6.3%）患者为非出血性脊髓挫伤，5例（10.4%）患者为脊髓横断，10例（20.8%）患者为硬膜外血肿，初始ASIA量表分级较高。与单平面矢状位mFFE和短tau反转恢复（STIR）序列相比，三平面mFFE序列的可视性评分更高。对于可视性评分为2的脊髓出血检测，三平面mFFE的敏感性为77%，其次单平面矢状位mFFE为38.5%，矢状位STIR图像为7.7%。26例（54.2%）患者在住院期间/随访期神经功能有改善，7例（14.6%）急性脊柱创伤患者未观察到改善。结论 与单矢状面mFFE和STIR序列相比，应用三平面mFFE序列能检测到更多的脊髓出血和椎体骨折，可视性评分更高。
