Spinal injuries in children: role of MR

To define the clinical and prognostic role of MR in a pediatric population with spinal cord injury. Fifteen children underwent MR 12 hours to 2 months postinjury using decoupled surface coils and ventilator support as needed. MR was correlated retrospectively with clinical, CT, and radiographic findings. On MR, of seven children with spinal cord neurologic deficits, four had hemorrhagic contusions, one had nonhemorrhagic contusion, one had extensive infarction, and one revealed a normal cord. All had persistent deficits on hospital discharge. Eight without cord neurologic deficit revealed no cord lesions on MR; this group included two with epidural hematoma, four with ligamentous disruption, and two with bone compression. Children may have extensive cord contusion and/or infarction with minor, remote, or no fracture dislocation. Because both hemorrhagic and nonhemorrhagic cord lesions found on MR were associated with significant, persistent cord deficits, the authors conclude that MR provides a practical tool for diagnosis/prognosis in children with acute/subacute spinal injury.