A qualitative MRI scoring system helps assess hypoxic-ischemic brain injury severity following cardiac arrest and may provide useful prognostic information in comatose cardiac arrest patients.
Damage to the spinal cord may be caused by a wide range of pathologies and generally results in profound functional disability. Therefore, a reliable diagnostic workup of the spine is very important because even relatively small lesions in this part of the central nervous system can have a profound clinical impact. This is primarily due to the dense arrangement of long fiber tracts extending to and from the extremities within the spinal cord. Because of its inherent sensitivity to soft tissues and its capability of displaying long segments of the vertebral column in one examination, MRI has become the method of choice for the detection and diagnosis of many disorders in the spine. A variety of innovative MRI methods have been developed to improve neuroimaging. Nevertheless, the application of these new methods to the spinal cord is, compared to its cephalad cousin, still not used that frequently. These techniques include the development of better pulse sequences and new MR contrast parameters that offer a wider spectrum of biophysical parameters in deriving a diagnosis. Overall, these new "cutting-edge" technologies have the potential to profoundly impact the ease and confidence of spinal disease interpretation and offer a more efficient diagnostic work-up of patients suffering from spinal disease.
Because of the widely acknowledged controversy in nonaccidental injury, the radiologist involved in such cases must be thoroughly familiar with the imaging, clinical, surgical, pathological, biomechanical, and forensic literature from all perspectives and with the principles of evidence-based medicine. Children with suspected nonaccidental injury versus accidental injury must not only receive protective evaluation but also require a timely and complete clinical and imaging workup to evaluate pattern of injury and timing issues and to consider the mimics of abuse. All imaging findings must be correlated with clinical findings (including current and past medical record) and with laboratory and pathological findings (eg, surgical, autopsy). The medical and imaging evidence, particularly when there is only central nervous system injury, cannot reliably diagnose intentional injury. Only the child protection investigation may provide the basis for inflicted injury in the context of supportive medical, imaging, biomechanical, or pathological findings.
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