Imaging of Spinal Trauma by Magnetic Resonance Imaging and Computed Tomography

MDCT is the preferred primary imaging modality in spine trauma patients. MRI gives superior contrast resolution for detection of soft tissue injuries and is the imaging modality of choice in detection of soft tissue injuries, spinal cord injuries, injury to intervertebral disc and ligaments. The aim of this study was to evaluate the role of MRI and MDCT in assessing the cord injuries, soft tissue injuries and bony injuries. The study was conducted on a total of thirty eight patients with spinal trauma which were referred between October 2015& September 2017. All the cases were investigated using MDCT and MRI. Assessment of spinal trauma was done using both the imaging modalities in all the patients and the findings were studied under the following categories Vertebral compression fractures, distraction fractures, posterior element fractures, vertebral listhesis, prevertebral soft tissue injuries, bone marrow edema, spinal canal narrowing, disc herniation, epidural hematoma, spinal cord injury and ligamentous injuries. In this cross-sectional study of 38 patients, 12 cases of Stable injuries and 26 cases of Unstable injuries were noted according to Denis classification.108 fractures were identified by CT and out of these, 52 fractures demonstrated bone marrow edema on MR examination and 56 fractures didnt show any evidence of bone marrow edema.76 % of compression fractures showed bone marrow edema as compared to 33 % and 26 % in distraction fractures and other fractures respectively. MDCT was superior to rest of the imaging modalities in the diagnosis of vertebral fractures, however, it is insensitive to diagnosis of spinal cord injuries. MR Imaging is the only imaging modality to assess spinal cord injury. MR imaging should be considered a primary imaging modality to assess epidural hematoma, traumatic disc herniation, ligamentous injury and spinal cord compression. Other modalities can be used in patients in whom MR imaging is contraindicated. MDCT and MRI are complementary studies in spinal trauma.