Purpose. To study the possibilities of MRI in the diagnosis of traumatic injuries of the spinal cord of the cervical spine.

Materials and methods. A total of 100 victims aged 39±16 years with spinal cord injury were examined. Of these, 86% are men, 14% are women. MRI images were obtained on a Signa HD, GE (1.5 T) scanner according to the standard technique using a head and neck coil. Patients in serious condition underwent tomography under mechanical ventilation. The primary MRI examination was performed within 48 hours after injury, and repeated ones after 1, 3 and 12 months.

Results. Six types of isolated and combined spinal cord injuries were identified: contusion (9%), external compression (9%), interruption (3%), contusion/compression with complete (45%) and partial (13%) limitation of reserve spaces spinal canal, external compression/edema (13%) of the spinal cord. The mortality rate within a month after the injury was 9%. Traumatic spinal cord injuries (83%) were studied in dynamics with the determination of the outcome and comparison with clinical data. Variants of trauma outcomes according to MRI data in victims: complete spinal injuries 26% (ASIA A/B 24%, C 2%), incomplete spinal injuries 37% (ASIA C/D 36%, В 1%), regression of traumatic changes in the spinal cord 20% (normalization of neurological status 18%, ASIA D 2%). A large number of cases (84%) of complete spinal injury (destruction of the entire diameter of the brain) was the result of a combination of interrelated two types of injury, contusion and compression. The following indicators of trauma severity were determined: hematomyeloischemia (58%), complete absence of CSF spaces (84%), generalized cerebral edema, degree of compression >20%. In case of incomplete spinal injuries, the dominant trauma during the initial diagnosis was spinal cord contusion (84%), in which there was a combined nature (76%), hematomyelia (5%), complete delimitation of the reserve spaces (51%). External compression of the spinal cord (70%) was the injury most frequently encountered in patients with favorable trauma outcomes. One of the conditions for complete neurological recovery was the absence of widespread edema of the medulla of the spinal cord when it was compressed. The sensitivity of MRI in the primary diagnosis of spinal cord injury was 92%, specificity 97%, overall accuracy 94%.

Conclusion. The use of MRI to assess injuries of the spinal cord of the cervical spine makes it possible to distinguish between reversible and irreversible changes in the medulla, predict the likelihood of an outcome of the disease, and also prevent secondary injuries due to the timely use of adequate therapeutic measures.