MAGNETIC-RESONANCE-IMAGING OF SEVERE FROSTBITE INJURIES

Frostbite injury causes damage by direct ice crystal formation at the cellular level with cellular dehydration and microvascular occlusion. Acute treatment is well defined with rapid tissue rewarming. Definitiv e surgical therapy is usually delayed until a clear level of demarcati on is seen. Technium (Tc)-99 bone scanning has become the standard ima ging study employed within the first several days to assess tissue per fusion and viability. We present 2 patients with severe frostbite inju ry in which magnetic resonance imaging (MRI) and magnetic resonance an giography (MRA) were compared to Tc-99 bone scans. MRI/MRA appears to be superior to bone scanning by allowing direct visualization of occlu ded vessels, imaging of surrounding tissues, and by showing a more cle ar-cut line of demarcation of ischemic tissue, MRI/MRA may also allow early intervention in cases of severe frostbite, thus preventing secon dary infection and increased cost.