Necessity of Immediate MRI Imaging in the Acute Care of Severely Injured Patients
Abstract
:1. Introduction
2. Methods
2.1. CT-Scan-Protocol
2.2. MRI-Scan-Protocol
2.3. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. Timing of MRI
3.3. Injury Overview
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Furlow, B. Whole-body computed tomography trauma imaging. Radiol. Technol. 2017, 89, 159CT–180CT. [Google Scholar] [PubMed]
- Huber-Wagner, S.; Lefering, R.; Kanz, K.G.; Biberthaler, P.; Stengel, D. The importance of immediate total-body CT scanning. Lancet 2017, 389, 502–503. [Google Scholar] [CrossRef] [Green Version]
- Hilbert-Carius, P.; Wurmb, T.; Lier, H.; Fischer, M.; Helm, M.; Lott, C.; Böttiger, B.W.; Bernhard, M. Care for Severely Injured Persons: Update of the 2016 S3 Guideline for the Treatment of Polytrauma and the Severely Injured. Der Anaesthesist 2017, 66, 195–206. [Google Scholar] [CrossRef] [PubMed]
- Odle, T. Emergency computed tomography. Radiol. Technol. 2020, 91, 267CT–287CT. [Google Scholar] [PubMed]
- Sarani, B.; Waring, S.; Sonnad, S.; Schwab, C.W. Magnetic resonance imaging is a useful adjunct in the evaluation of the cervical spine of injured patients. J. Trauma Acute Care Surg. 2007, 63, 637–640. [Google Scholar] [CrossRef] [PubMed]
- Laur, O.; Nandu, H.; Titelbaum, D.S.; Nunez, D.B.; Khurana, B. Nontraumatic spinal cord compression: MRI primer for emergency department radiologists. Radiographics 2019, 39, 1862–1880. [Google Scholar] [CrossRef] [PubMed]
- Kawakyu-O’Connor, D.; Bordia, R.; Nicola, R. Magnetic resonance imaging of spinal emergencies. Magn. Reson. Imaging Clin. N. Am. 2016, 24, 325–344. [Google Scholar] [CrossRef] [PubMed]
- Hauwe, L.v.D.; Sundgren, P.C.; Flanders, A.E. Spinal trauma and spinal cord injury (Sci). In Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging; Hodler, J., Kubik-Huch, R.A., von Schulthess, G.K., Eds.; Springer: Cham, Switzerland, 2020; pp. 231–240. [Google Scholar]
- Khurana, B.; Karim, S.M.; Zampini, J.M.; Jimale, H.; Cho, C.H.; Harris, M.B.; Sodickson, A.D.; Bono, C.M. Is focused magnetic resonance imaging adequate for treatment decision making in acute traumatic thoracic and lumbar spine fractures seen on whole spine computed tomography? Spine J. 2019, 19, 403–410. [Google Scholar] [CrossRef] [PubMed]
- Popp, D.; Thiedemann, C.; Baumler, W.; Ernstberger, A.; Alt, V.; Schicho, A. Modified split-scan computed tomography (CT) diagnostics of severely injured patients: First results from a level I trauma center using a dedicated head-and-neck CT-angiogram for the detection of cervical artery dissections. J. Clin. Med. 2020, 9, 2568. [Google Scholar] [CrossRef] [PubMed]
- Yamada, S.; Ohnishi, H.; Takamura, Y.; Takahashi, K.; Hayashi, M.; Kodama, Y.; Kuga, Y.; Nakase, H.; Nakagawa, I. Diagnosing intra-cranial and cervical artery dissection using MRI as the initial modality. J. Clin. Neurosci. 2016, 33, 177–181. [Google Scholar] [CrossRef] [PubMed]
- AWMF. S2k Leitlinie Polytraumaversorgung Im Kindesalter; AWMF: Marburg, Germany, 2020. [Google Scholar]
- Wenger, K.J.; Hattingen, E. Fast MRI sequences for clarification of acute neurological symptoms. Der Radiologe 2020, 60, 208–215. [Google Scholar] [CrossRef] [PubMed]
- Meinig, H.; Matschke, S.; Ruf, M.; Pitzen, T.; Disch, A.; Jarvers, J.S.; Herren, C.; Weiss, T.; Jung, M.K.; Ruther, H.; et al. Diagnostics and Treatment of Cervical Spine Trauma in Pediatric Patients: Recommendations from the Pediatric Spinal Trauma Group. Der Unfallchirurg 2020, 123, 252–268. [Google Scholar] [CrossRef] [PubMed]
- Ferrazzano, P.A.; Rosario, B.L.; Wisniewski, S.R.; Shafi, N.I.; Siefkes, H.M.; Miles, D.K.; Alexander, A.L.; Bell, M.J. Use of magnetic resonance imaging in severe pediatric traumatic brain injury: Assessment of current practice. J. Neurosurg. Pediatr. 2019, 23, 471–479. [Google Scholar] [CrossRef] [PubMed]
- Gordic, S.; Alkadhi, H.; Simmen, H.P.; Wanner, G.; Cadosch, D. Characterization of indeterminate spleen lesions in primary CT after blunt abdominal trauma: Potential role of MR imaging. Emerg. Radiol. 2014, 21, 491–498. [Google Scholar] [CrossRef] [PubMed]
- Provenzale, J.M.; Sarikaya, B. Comparison of test performance characteristics of MRI, MR angiography; CT angiography in the diagnosis of carotid and vertebral artery dissection: A review of the medical literature. Am. J. Roentgenol. 2009, 193, 1167–1174. [Google Scholar] [CrossRef] [PubMed]
- Liang, T.; Tso, D.K.; Chiu, R.Y.; Nicolaou, S. Imaging of blunt vascular neck injuries: A review of screening and imaging modalities. Am. J. Roentgenol. 2013, 201, 884–892. [Google Scholar] [CrossRef] [PubMed]
- Vertinsky, A.T.; Schwartz, N.E.; Fischbein, N.J.; Rosenberg, J.; Albers, G.W.; Zaharchuk, G. Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. Am. J. Neuroradiol. 2008, 29, 1753–1760. [Google Scholar] [CrossRef] [Green Version]
CT Group | MRI Group | |
---|---|---|
Number (n) | 568 | 12 |
Male (n/%) | 410/72.2% | 6/50.0% |
Age (years ± SD) | 48.96 ± 21.82 | 44.67 ± 21.36 |
ISS (∅ ± SD) | 30.60 ± 15.86 | 32.73 ± 17.92 |
GCS (∅ ± SD) | 10.71 ± 4.84 | 11.75 ± 4.40 |
Intubation (n/%) | 317/60.3% | 3/25.0% |
Door-to-image (min ± SD) | 27.48 ± 8.03 | 111.45 ± 45.9 |
Working Hours | Number | Percent (%) |
---|---|---|
Dayshift Monday-Friday; 8 a.m.–4 p.m. | 4 | 33.33 |
Nightshift Monday-Friday; 4 p.m.–8 a.m. | 6 | 50 |
Weekend Saturday + Sunday | 2 | 16.67 |
CT Group | MRI Group | |
---|---|---|
Head (n/%) | 286/50.4 | 5/41.7 |
Face (n/%) | 62/10.9 | 0/0 |
Thorax (n/%) | 277/48.8 | 5/41.7 |
Abdomen (n/%) | 79/13.9 | 0/0 |
Spine (n/%) | 96/16.9 | 10/83.3 |
Upper extremities (n/%) | 28/4.9 | 0/0 |
Lower extremities (n/%) | 117/20.6 | 0/0 |
Pelvic (n/%) | 87/15.3 | 2/16.7 |
Neck (n/%) | 24/4.2 | 3/25 |
Soft tissues (n/%) | 6/1.1 | 0/0 |
Sex | Age in Years | Diagnosis MRI (Non Detectable by CT) | Therapeutic Consequence | Duration in Min | No. of Sequences |
---|---|---|---|---|---|
m | 36 | Lig. flavum rupture, epidural hematoma, Lig. long. post. Rupture, fracture T11 | y | 16 | 3 |
m | 19 | None | n | 42 | 10 |
m | 40 | None | n | 24 | 6 |
f | 17 | Myelopathy, vertebral artery injury | y | 43 | 6 |
m | 18 | Internal carotid artery injury | y | 20 | 5 |
f | 50 | Myelopathy, Lig. Long. Ant. and post. Rupture | y | 80 | 7 |
f | 75 | Discal injury, myelopathy | y | 15 | 4 |
m | 47 | Myelopathy | n | 51 | 7 |
f | 80 | Myelopathy | n | 11 | 4 |
f | 50 | Internal carotid artery injury bilateral, stroke | y | 16 | 8 |
f | 37 | Epidural hematoma, myelopathy | n | 14 | 5 |
m | 67 | Fracture T4+5, vertebral artery dissections, myelopathy | y | 50 | 11 |
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Popp, D.; Kerschbaum, M.; Mahr, D.; Thiedemann, C.; Ernstberger, A.; Wiesinger, I.; Bäumler, W.; Alt, V.; Schicho, A. Necessity of Immediate MRI Imaging in the Acute Care of Severely Injured Patients. Medicina 2021, 57, 982. https://doi.org/10.3390/medicina57090982
Popp D, Kerschbaum M, Mahr D, Thiedemann C, Ernstberger A, Wiesinger I, Bäumler W, Alt V, Schicho A. Necessity of Immediate MRI Imaging in the Acute Care of Severely Injured Patients. Medicina. 2021; 57(9):982. https://doi.org/10.3390/medicina57090982
Chicago/Turabian StylePopp, Daniel, Maximilian Kerschbaum, Daniel Mahr, Claudius Thiedemann, Antonio Ernstberger, Isabel Wiesinger, Wolf Bäumler, Volker Alt, and Andreas Schicho. 2021. "Necessity of Immediate MRI Imaging in the Acute Care of Severely Injured Patients" Medicina 57, no. 9: 982. https://doi.org/10.3390/medicina57090982