Agha Tabari Khaled, Swami Shivling S, Kasagga Alousious, Assefa Amanuel Kefyalew, Amin Maysaa N, Hashish Rahma, Yu Ann Kashmer
Radiology, Queen Elizabeth University Hospital, Glasgow, GBR.
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2025 Jun 30;17(6):e87040. doi: 10.7759/cureus.87040. eCollection 2025 Jun.
Spinal cord injury (SCI) happens when the spinal cord is damaged, which can be caused by different types of trauma or other non-traumatic factors. These injuries are a major contributor to disability and long-term morbidity on a global scale, often resulting in severe neurological deficits and complications. While radiography and computed tomography (CT) frequently provide guidance for initial assessment, magnetic resonance imaging (MRI) is the most effective method for imaging soft tissues. MRI is essential in identifying and managing SCI because it can demonstrate relevant details, detect bleeding, swelling, and ligament damage, and offer valuable insights for prognosis. This traditional review evaluates the role of MRI in managing SCI by examining relevant literature. The review examines MRI's diagnostic accuracy, its value in predicting outcomes, and how it influences clinical decisions. The paper provides a well-rounded view of its advantages and limitations. It includes full-text review articles and meta-analyses published in English between 1996 and 2024, with additional studies included if the selected articles reference them. Our findings demonstrate that MRI is crucial for diagnosing acute SCI due to its ability to provide detailed visualization of spinal cord pathology, which other imaging techniques often miss. It aids in prognosis, with features like intramedullary hemorrhage and lesion length correlating with neurological recovery; however, features of edema and cord compression are not as clear-cut when it comes to predicting outcomes. MRI also influences surgical planning and timing through its ability to assist in determining the need for decompression and stabilization procedures. Future research should focus on developing standardized MRI criteria and conducting high-quality trials to enhance the clinical utility, prognostic reliability, and diagnostic accuracy in the treatment of SCI.
脊髓损伤（SCI）是指脊髓受到损伤，其可由不同类型的创伤或其他非创伤性因素引起。这些损伤是全球范围内导致残疾和长期发病的主要原因，常导致严重的神经功能缺损和并发症。虽然X线摄影和计算机断层扫描（CT）常常为初始评估提供指导，但磁共振成像（MRI）是软组织成像的最有效方法。MRI在识别和管理脊髓损伤方面至关重要，因为它可以显示相关细节，检测出血、肿胀和韧带损伤，并为预后提供有价值的见解。本传统综述通过查阅相关文献评估MRI在管理脊髓损伤中的作用。该综述考察了MRI的诊断准确性、其在预测预后方面的价值以及它如何影响临床决策。本文全面阐述了其优点和局限性。它包括1996年至2024年间以英文发表的全文综述文章和荟萃分析，若所选文章引用了其他研究，则将其纳入。我们的研究结果表明，MRI对于诊断急性脊髓损伤至关重要，因为它能够详细显示脊髓病变，而其他成像技术常常遗漏这些病变。它有助于预后评估，髓内出血和病变长度等特征与神经功能恢复相关；然而，在预测预后方面，水肿和脊髓受压的特征并不那么明确。MRI还通过其协助确定减压和稳定手术需求的能力影响手术规划和时机。未来的研究应专注于制定标准化的MRI标准，并开展高质量试验，以提高脊髓损伤治疗中的临床实用性、预后可靠性和诊断准确性。
