创伤室中儿童和青少年初级护理中适应性全身MRI的结果。
Results of an adapted whole-body MRI in the primary care of children and adolescents in the trauma room.
作者信息
Hufnagel Silvia J, Brinkemper Alexis, Pätzholz Simon, Cibura Charlotte, Nicolas Volkmar, Schildhauer Thomas A, Kruppa Christiane
机构信息
Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bürkle de la Camp-Platz 1, 44789, Bochum, Germany.
Department of Radiology and Interventional Radiology, BG University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Bürkle de la Camp-Platz 1, 44789, Bochum, Germany.
出版信息
J Orthop Surg Res. 2025 Apr 19;20(1):394. doi: 10.1186/s13018-025-05802-3.
BACKGROUND
In diagnostic imaging as part of pediatric polytrauma management radiation exposure and diagnostic benefit of a whole-body computed tomography must be weighed up against each other. Performing an adapted polytrauma magnetic resonance imaging (MRI) could be a sensible alternative in some cases. The aim of this study was to show what findings are made in the MRI and if this has consequences for further diagnosis and therapy.
METHODS
We performed a retrospective evaluation of the adapted polytrauma MRI examination as part of the primary survey in trauma room care of children and adolescents (indication was made individually) between 05/2016 and 12/2022 in a level 1 trauma center. Demographic data, cause of the accident, findings obtained during the MRI, additive radiological diagnostics performed, time between admission to hospital and MRI and the therapeutic consequence of the MRI findings were evaluated.
RESULTS
33 children (21 boys, 12 girls) with an average age of 11.3 years (2.9-17.6 years) were evaluated. The majority of accident mechanisms were traffic accidents in 14 (42.4%) cases and a fall from a height of > 3 m in 6 cases (18.2%). Additional radiological diagnosis was performed in 20 (60.6%) cases. Time between admission and MRI was in average 47.58 min. In 23 (69.7%) patients, 31 injuries were detected on MRI such as spinal injury (9 cases), soft tissue injury (9), skull/brain injury (4), bony lesion of the extremities/shoulder girdle (4), pelvic injury (3), and lung injury (2). The additional injuries identified on MRI did not lead to surgical intervention in any case.
CONCLUSIONS
It seems reasonable to perform an MRI in children admitted to the trauma room, if available and if the children are circulatory stable. In particular, injuries of the spine and pelvis can be detected without additional radiation diagnostics, even if they usually do not require surgical intervention.
TRIAL REGISTRATION
DRKS, DRKS00036020. Registered 28 January 2025-Retrospectively registered, https://www.drks.de/DRKS00036020 .
背景
在儿科多发伤管理中，作为诊断成像的一部分，全身计算机断层扫描的辐射暴露和诊断益处必须相互权衡。在某些情况下，进行适应性多发伤磁共振成像（MRI）可能是一种明智的选择。本研究的目的是展示MRI检查的结果，以及这是否会对进一步的诊断和治疗产生影响。
方法
我们对2016年5月至2022年12月期间在一级创伤中心对儿童和青少年进行的创伤室护理初级调查的一部分——适应性多发伤MRI检查进行了回顾性评估（适应症是单独确定的）。评估了人口统计学数据、事故原因、MRI检查期间获得的结果、进行的附加放射学诊断、入院至MRI检查的时间以及MRI检查结果的治疗后果。
结果
评估了33名儿童（21名男孩，12名女孩），平均年龄为11.3岁（2.9 - 17.6岁）。大多数事故机制为交通事故，共14例（42.4%），6例（18.2%）为从高于3米处坠落。20例（60.6%）进行了附加放射学诊断。入院至MRI检查的平均时间为47.58分钟。在23例（69.7%）患者中，MRI检查发现了31处损伤，如脊柱损伤（9例）、软组织损伤（9例）、颅骨/脑损伤（4例）、四肢/肩胛带骨病变（4例）、骨盆损伤（3例）和肺损伤（2例）。MRI检查发现的附加损伤在任何情况下均未导致手术干预。
结论
对于入住创伤室的儿童，如果有条件且儿童循环稳定，进行MRI检查似乎是合理的。特别是，即使脊柱和骨盆损伤通常不需要手术干预，也可以在不进行附加放射学诊断的情况下检测到。
试验注册
DRKS，DRKS00036020。于2025年1月28日注册——回顾性注册，https://www.drks.de/DRKS00036020 。
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