Investigation of choice in a patient brought with traumatic paraplegia: March 2005
Ans. D: MRI Scan Radiological examination shows no correlation between the severity of the injury on the X-rays and the degree of the neurological deficit. CT scan may be indicated in cases with incomplete and increasing paralysis. MRI scan has become the imaging modality of choice for these cases. MRIs of the thoracolumbar spine provide information that is not available using CT scans. Early in an injury, T1-weighted spin-echo (SE) axial and sagittal images may demonstrate the high signal intensity related to acute hemorrhage, including the rare complicating epidural hemorrhage. Both T2-weighted fast SE (FSE) and fluid-attenuated inversion recovery (FLAIR) images demonstrate the high signal intensity associated with edema of bone marrow fat. Gradient-echo T2-weighted images best outline the shape and structure of the veebral body and the posterior spinal elements. These MRI sequences are superior to CT scans for detection of a posttraumatic herniated disk, ligamentous edema, and spinal cord compression. The resolution of MRI used in the detection of spinal fractures is limited. Although gradient-echo and T1-weighted SE images outline fractures well, minimally displaced fractures are difficult to see.
Plain X-ray
Myelography
CT scan
MRI scan