196. Rapid MRI protocol for acute spinal cord trauma and cord compression

BACKGROUND CONTEXT Timely management of acute spinal cord injury is based on a combination of accurate clinical exam and advanced imaging to detect neurologic, bony, and soft tissue injury. A dedicated acute spinal cord injury MRI protocol was implemented and compared to the standard MRI protocol at our level 1 trauma center. PURPOSE We aim to demonstrate the utility and effectiveness of a dedicated acute spinal cord MRI protocol. STUDY DESIGN/SETTING Retrospective. PATIENT SAMPLE A total of 382 consecutive patients presenting to a level 1 trauma center with evidence of spine trauma or cord compression necessitating MRI. OUTCOME MEASURES MRI scan time. METHODS We implemented a dedicated, priority MRI protocol with preferential sagittal T1, Stir, T2 and axial T1, T2, post axial T1 fat-suppression, fat-suppression series of the cervical, thoracic and lumbar spine. We compared this novel protocol with the standard cervical, thoracic and lumbar spine MRI protocols. Statical analysis was performed with t-test to compare the standard and novel protocols. RESULTS A total of 354 MRI scans conducted under the standard MRI protocol between July and November of 2021 were reviewed along with 28 MRI scans performed under the novel acute spinal cord injury protocol from November 2021 to April 2022. The median acquisition time for standard cervical, thoracic and lumbar spine MRI was 126.5 (Q1-Q3: 104 – 154) minutes. Forty percent of standard MRI studies were found to be a combination of cervical, thoracic, and/or lumbar spine studies. The novel acute spinal cord injury MRI protocol acquisition time was a median 50.0 (Q1-Q3: 26.2 – 74.3) minutes. The MRI protocol scan time was reduced from 68.6 mins (standard) to 24.9 mins (novel spinal cord injury) demonstrating a 63.7% reduction in time, not accounting for positioning and time to check scan. During this period an average time savings per patient of 76.5 minutes was achieved. At our institution, this approximates diagnostic MRI cost savings of $2,335.80 per patient. CONCLUSIONS The novel, dedicated acute spinal cord injury MRI protocol demonstrated shorter acquisition time and decreased cost per patient compared to previous MRI protocols at our level 1 trauma center. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. Timely management of acute spinal cord injury is based on a combination of accurate clinical exam and advanced imaging to detect neurologic, bony, and soft tissue injury. A dedicated acute spinal cord injury MRI protocol was implemented and compared to the standard MRI protocol at our level 1 trauma center. We aim to demonstrate the utility and effectiveness of a dedicated acute spinal cord MRI protocol. Retrospective. A total of 382 consecutive patients presenting to a level 1 trauma center with evidence of spine trauma or cord compression necessitating MRI. MRI scan time. We implemented a dedicated, priority MRI protocol with preferential sagittal T1, Stir, T2 and axial T1, T2, post axial T1 fat-suppression, fat-suppression series of the cervical, thoracic and lumbar spine. We compared this novel protocol with the standard cervical, thoracic and lumbar spine MRI protocols. Statical analysis was performed with t-test to compare the standard and novel protocols. A total of 354 MRI scans conducted under the standard MRI protocol between July and November of 2021 were reviewed along with 28 MRI scans performed under the novel acute spinal cord injury protocol from November 2021 to April 2022. The median acquisition time for standard cervical, thoracic and lumbar spine MRI was 126.5 (Q1-Q3: 104 – 154) minutes. Forty percent of standard MRI studies were found to be a combination of cervical, thoracic, and/or lumbar spine studies. The novel acute spinal cord injury MRI protocol acquisition time was a median 50.0 (Q1-Q3: 26.2 – 74.3) minutes. The MRI protocol scan time was reduced from 68.6 mins (standard) to 24.9 mins (novel spinal cord injury) demonstrating a 63.7% reduction in time, not accounting for positioning and time to check scan. During this period an average time savings per patient of 76.5 minutes was achieved. At our institution, this approximates diagnostic MRI cost savings of $2,335.80 per patient. The novel, dedicated acute spinal cord injury MRI protocol demonstrated shorter acquisition time and decreased cost per patient compared to previous MRI protocols at our level 1 trauma center.