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ECR 2019 / C-3254
Magnetic Resonance Imaging of Spinal Emergencies: Guide for the radiologist on call
Congress: ECR 2019
Poster No.: C-3254
Type: Educational Exhibit
Keywords: Neuroradiology spine, Emergency, Musculoskeletal spine, MR, Diagnostic procedure, Acute
Authors: M. Alonso, M. Fajardo Puentes, M. D. M. Velasco Casares, G. C. Fernández-Pérez, M. Hernandez Herrero, A. Ginés Santiago, S. G. Rizzo, M. A. de la Fuente; Valladolid/ES


Myelopathy, is a damage to the spinal cord resulting in a change, either temporary or permanent, in the cords normal motor, sensory or autonomic function; but the term also includes meningeal or parameningeal space damage or dysfunction. 


Patients with spinal cord injury (SCI) often have permanent and devastating neurologic deficits and disability. Traumatic injuries, vascular diseases, tumoral diseases, infections and inflammatory and autoimmune processes may affect the spinal cord due to its confinement in a very small place. A detailed history (injury duration, severity and extens) and adequate neurological examination is really important, however, imaging will help to identify the etiology appropriately. Magnetic resonance imaging (MRI) is the method of choice for evaluation the acutely injured spine. Many of the processes affecting the spinal cord may be reversible if recognized and treated early. The first aim is to distinguish trough compressive and non-compressive etiologies. The majority of spinal cord diseases may be treated medically, with surgical treatment reserved for compresive disorders, which is a neurological emergency. 


Considering that many patients may be neurologically unstable, Radiologist must provide supervision while the MRI is conducted. In patients who are in stable condition, ideally total spine magnetic resonance (extending from the skull base to the lumbosacral junction) should be performed in sagital T1-,T2-weighted, short tau inversion recovery (STIR) sequences as well as axial T1-and T2-weighted sequences. Depending on the clinical concern, additional sequences should be considered, gradient-recalled echo T2*, mielographic sequences or sequences after intravenous Gadolinium administration. 



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