Absence of T2 flow voids in the vertebral arteries on cervical spine MRI in patients with trauma

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-08 DOI:10.1016/j.ejrad.2025.112163

Tae Ran Ahn , Jun Seong Kim , Jiyoung Yoon , Jungbok Lee

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Abstract

Purpose

To investigate patients with cervical spine trauma with absence of T2 flow voids in the vertebral arteries (VAs) on cervical spine MRI, assess the proportion of VA occlusion and subsequent brain infarction, and identify injury patterns associated with brain infarction.

Methods

Patients with absence of T2 flow voids in the VA on cervical spine MRI for acute trauma in a regional trauma center between 2019 and 2023 were retrospectively evaluated. Injury characteristics were assessed, and the absence of T2 flow voids, an indicator of VA injury and brain infarction, was confirmed by angiography and brain MRI. Univariate exact logistic regression was employed to evaluate the association of cervical spine injury characteristics with the presence of brain infarction in the VA territory.

Results

Of 683 patients, 42 (6.1 %) showed VA T2 flow void absence. The absence of T2 flow voids was predominantly unilateral (95.2 %). Coexisting transverse foramen fractures, discoligamentous complex (DLC) disruptions, and cord injuries were recorded in 61.9 %, 38.1 %, and 57.1 % of patients, respectively. Overall, 45.2 % and 26.2 % of patients had VA occlusion and brain infarction, respectively, with 14.3 % having both. Brain infarction was significantly associated with DLC disruptions (OR = 8.26, p = 0.040) and spinal cord injuries (OR = 12.09, p = 0.014). Two patients with bilateral VA involvement both developed brain infarction.

Conclusion

In patients with cervical spine trauma and an absence of T2 flow voids in the VAs on MRI, VA occlusion and subsequent brain infarction were frequently observed. Brain infarction in these cases was associated with DLC disruptions or spinal cord injuries.

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创伤患者颈椎MRI椎动脉中T2血流空洞的缺失

目的探讨颈椎外伤伴椎动脉T2血流空洞缺失的颈椎MRI表现，评估椎动脉闭塞与脑梗死的比例，识别与脑梗死相关的损伤模式。方法回顾性分析2019年至2023年在某区域创伤中心进行的急性创伤颈椎MRI上VA无T2血流空洞的患者。评估损伤特征，并通过血管造影和脑MRI证实T2血流空洞的缺失，这是VA损伤和脑梗死的指标。采用单变量精确逻辑回归来评估颈椎损伤特征与脑梗死在VA区域的存在之间的关系。结果683例患者中42例（6.1%）表现为VA T2血流空洞缺失。T2血流空洞的缺失主要是单侧的（95.2%）。同时存在横孔骨折、双韧带复合体（DLC）破坏和脊髓损伤的患者分别为61.9%、38.1%和57.1%。总的来说，45.2%和26.2%的患者分别有VA闭塞和脑梗死，14.3%的患者两者兼有。脑梗死与DLC中断（OR = 8.26, p = 0.040）和脊髓损伤（OR = 12.09, p = 0.014）显著相关。两例双侧VA受累患者均发生脑梗死。结论颈椎外伤患者在MRI上无血管内T2血流空洞时，经常观察到血管阻塞和随后的脑梗死。这些病例中的脑梗死与DLC中断或脊髓损伤有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.