PURPOSE: To define the clinical and prognostic role of MR in a pediatr
ic population with spinal cord injury. METHODS: Fifteen children under
went MR 12 hours to 2 months postinjury using decoupled surface coils
and ventilator support as needed. MR was correlated retrospectively wi
th clinical, CT, and radiographic findings. RESULTS: On MR, of seven c
hildren with spinal cord neurologic deficits, four had hemorrhagic con
tusions, one had nonhemorrhagic contusion, one had extensive infarctio
n, and one revealed a normal cord. All had persistent deficits on hosp
ital discharge. Eight without cord neurologic deficit revealed no cord
lesions on MR; this group included two with epidural hematoma, four w
ith ligamentous disruption, and two with bone compression. CONCLUSIONS
: Children may have extensive cord contusion and/or infarction with mi
nor, remote, or no fracture dislocation. Because both hemorrhagic and
nonhemorrhagic cord lesions found on MR were associated with significa
nt, persistent cord deficits, the authors conclude that MR provides a
practical tool for diagnosis/prognosis in children with acute/subacute
spinal injury.