Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

In patients with acute traumatic cervical spinal cord injury, it is difficult to make a precise diagnosis of the main site of the injury, the severity of cord damage, and the prognosis of neurological complications. Objective: To determine which images provide the most useful information and the best time to perform prognostic MRI. Design: The severity of neurological complications was assessed using the ASIA impairment scale. MRI was first performed within 48 h of injury, and was subsequently performed after 2-3 weeks, 3 months, 6 months, and 1 year. Setting: Inpatient SCI medicine unit. Subjects: Seventy-five patients with acute traumatic cervical spinal cord injury (9 women and 66 men) aged from 19-89 years (mean: 54.7 years). Results: Four characteristic patterns of signal changes were observed on MRI. These patterns correlated well with the severity of spinal cord damage and the clinical outcome. Conclusion: T2-weighted images provided the most useful information, and the best times for prognostic imaging were at the time of injury and 2-3 weeks later.