Limited sequence MRI to improve standards of care for suspected cauda equina syndrome
| Autor: | Nicholas Beresford-Cleary, Stuart Blagg, Ramal Gnanasekaran, R J Hughes, Daniel Rolton, Karim Aboelmagd, Edward Seel, Tariq Aboelmagd |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent Cauda equina syndrome Cauda Equina Syndrome Young Adult Humans Medicine Orthopedics and Sports Medicine Retrospective Studies Sequence (medicine) medicine.diagnostic_test business.industry Lumbosacral Region Standard of Care Magnetic resonance imaging Middle Aged Decompression Surgical medicine.disease Magnetic Resonance Imaging Quality Improvement Female Surgery Radiology business |
| Zdroj: | The Bone & Joint Journal. :501-505 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.102b4.bjj-2019-0645.r2 |
| Popis: | Aims Early cases of cauda equina syndrome (CES) often present with nonspecific symptoms and signs, and it is recommended that patients undergo emergency MRI regardless of the time since presentation. This creates substantial pressure on resources, with many scans performed to rule out cauda equina rather than confirm it. We propose that compression of the cauda equina should be apparent with a limited sequence (LS) scan that takes significantly less time to perform. Methods In all, 188 patients with suspected CES underwent a LS lumbosacral MRI between the beginning of September 2017 and the end of July 2018. These images were read by a consultant musculoskeletal radiologist. All images took place on a 3T or 1.5T MRI scanner at Stoke Mandeville Hospital, Aylesbury, UK, and Royal Berkshire Hospital, Reading, UK. Results The 188 patients, all under the age of 55 years, underwent 196 LS lumbosacral MRI scans for suspected CES. Of these patients, 14 had cauda equina compression and underwent emergency decompression. No cases of CES were missed. Patients spent a mean 9.9 minutes (8 to 10) in the MRI scanner. Conclusion Our results suggest that a LS lumbosacral MRI could be used to diagnose CES safely in patients under the age of 55 years, but that further research is needed to assess safety and efficacy of this technique before changes to existing protocols can be recommended. In addition, work is needed to assess if LS MRIs can be used throughout the spine and if alternative pathology is being considered. Cite this article: Bone Joint J 2020;102-B(4):501–505. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|