17 hours ago
MRI Detects Missed Cervical Injuries After Negative CT
TOPLINE:
MRI identified missed cervical spine injuries in 17% of patients with trauma who had negative CT results, prompting treatment changes in 4% of them.
METHODOLOGY:
Researchers conducted a meta-analysis of 36 studies involving 6784 patients with trauma who underwent cervical spine MRI after a negative CT scan.
Most included studies were retrospective (n = 29).
The primary outcome was the proportion of patients with missed injuries. Changes in treatment due to MRI findings were also evaluated.
TAKEAWAY:
MRI identified missed injuries in 17% of patients with initially negative CT findings. Most injuries were soft tissue injuries, with 40.1% involving the intervertebral disk and posterior ligamentous complex and 2% due to prevertebral edema.
Missed injuries were more common in children than in adults (32% vs 13%).
Alert patients had a higher rate of missed injuries than obtunded patients (28% vs 14%).
MRI findings led to treatment changes in 4% of patients, most of which were related to the intervertebral disk and the ligaments supporting the spine, highlighting the role of MRI in reducing missed injury rates through its superior soft tissue visualization compared with CT.
IN PRACTICE:
"While there was no established algorithm for the indication of MRI after negative CT findings, MRI should be considered under certain circumstances to prevent missing injuries. This includes the pediatric population, obtunded patients, patients experiencing persistent pain, and when there are uncertain clinical examination findings," the authors wrote.
SOURCE:
This study was led by Jung Hahn Yong, National University of Singapore, Singapore. It was published online on May 23, 2025, in European Spine Journal.
LIMITATIONS:
Most included studies were retrospective. Variability in patient age groups and incomplete reporting of MRI findings leading to treatment changes could have limited the generalizability of the results. Researchers also noted moderate-to-high heterogeneity between studies.
DISCLOSURES:
This study did not receive any funding. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
