IVIRI of Acute Cervical Injury: Correlation with Neurologic Deficit

PURPOSE: To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. MATERIALS AND METHODS: 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1WI (TR/TE :500/20), gradient-echo (TR/TE :300/14), sagittal T1WI (TR/TE:500/20), proton (TR/TE :2000. 20 msec), T2WI (TR/TE :2000/80) were performed. In 11 pateints, post-enhancement T1WI was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. RESULTS: 15 patients had flexion injury, seven had extension injury and three had injury of unknon mechanism. Twelve patients showed /so-signal intensity on T1WI and high signal intensity on T2WI. Three patients showed low signal intensity on T1WI and high signal intensity on T2WI. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16(64%), 17(68%), 15(60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6(eight patients) and C5(five patients). CONCLUSION: MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent.

Detectability of Extrahepatic Duct Stones: A Comparison between Nonenhanced and Enhanced CT

PURPOSE: A study was performed to compare the detectability of extrahepatic duct stones between nonenhanced and enhanced computed tomography(CT). MATERIALS AND METHODS: Consecutive 30 patients with extrahepatic duct stones were analyzed with special attention to the detectability of stones between nonenhanced and enhanced CT. The extrahepatic duct was further divided into two segments, one above(suprapancereatic) and the other in(intrapancreatic) the head of the pancreas. Conspicuity of the stone was graded as "visible", "suspicious", and "invisible". Three radiologists reviewed the CT images without prior information and determined the location of stone and grade of their conspicuity. RESULTS: The stones were located at the suprapancreatic common duct in 5 patients, intrapancreatic common duct, in 15 patients and both portion of the duct in 10 patients. There was no difference in the detection rate of stones between the two images at suprapancreatic common duct, and was 93%, However, the rate at intrapancreatic common duct was 95% and 64% on nonenhanced and enhanced CT scans, respectively. The overall detection rate was 95% on nonenhance CT and 75% on enhanced CT. CONCLUSION: We concluded that nonenhanced CT was prerequisite to evaluate the extrahepatic duct stones in addition to enhanced CT.