The multitude of symptoms following a whiplash injury has given rise to much discussion because of the lack of objective radiological findings. The ligaments that stabilize the upper cervical spine can be injured. Dynamic kine magnetic resonance imaging (dMRI) may reveal the pathological motion patterns caused by injury to these ligaments. To compare the findings and motion patterns in the upper cervical spine, 25 whiplash trauma patients with longstanding pain, limb symptoms and loss of balance indicating a problem at the level of C0–C2, as well as matched healthy controls were imaged using dMRI. Imaging was performed with an Intera 1.5 T (Philips Healthcare, USA) magnet. A physiotherapist performed the bending and rotation of the upper cervical spine for the subjects to ensure that the movements were limited to the C0–C2 level. An oblique coronal T2- and proton density-weighted sequence and a balanced fast field echo axial sequence were used. The movements between C0–C2 and the signal from the alar ligaments were analyzed. Contact of the transverse ligament and the medulla in rotation was seen in two patients. The signal from the alar ligaments was abnormal in 92% of the patients and in 24% of the control subjects (P<0.0001). Abnormal movements at the level of C1–C2 were more common in patients than in controls (56% versus 20%, P=0.028). Whiplash patients with longstanding symptoms had both more abnormal signals from the alar ligaments and more abnormal movements on dMRI at the C0–C2 level than controls.

中文翻译：

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鞭打患者以及年龄和性别匹配对照中的动态运动磁共振成像。

由于缺乏客观的放射学发现，鞭打损伤后的许多症状引起了很多讨论。稳定上颈椎的韧带可能会受伤。动态血管磁共振成像（dMRI）可能会揭示这些韧带损伤所引起的病理运动模式。为了比较上颈椎的发现和运动方式，使用dMRI对25例长期遭受鞭痛，肢体症状和平衡失调表示C0–C2水平有问题的鞭打创伤患者以及匹配的健康对照进行了成像。成像使用Intera 1.5 T（美国飞利浦医疗公司）磁体进行。物理治疗师对受试者进行了上颈椎的弯曲和旋转，以确保将运动限制在C0–C2水平。使用了倾斜的冠状T2和质子密度加权序列以及平衡的快速场回波轴向序列。分析了C0–C2与前臂韧带信号之间的运动。在两名患者中观察到横韧带和旋转的延髓接触。在92％的患者和24％的对照受试者中，来自韧带的信号异常（P <0.0001）。患者的C1-C2水平异常运动比对照组更常见（56％比20％，P = 0.028）。具有长期症状的Whiplash患者与对照组相比，既有来自韧带的异常信号，也有在MRI上C0–C2水平的异常运动。分析了C0–C2与前臂韧带信号之间的运动。在两名患者中观察到横韧带和旋转的延髓接触。在92％的患者和24％的对照受试者中，来自韧带的信号异常（P <0.0001）。患者的C1-C2水平异常运动比对照组更常见（56％比20％，P = 0.028）。具有长期症状的Whiplash患者与对照组相比，既有来自韧带的异常信号，也有在MRI上C0–C2水平的异常运动。分析了C0–C2与前臂韧带信号之间的运动。在两名患者中观察到横韧带和旋转的延髓接触。在92％的患者和24％的对照受试者中，来自韧带的信号异常（P <0.0001）。患者的C1-C2水平异常运动比对照组更常见（56％比20％，P = 0.028）。具有长期症状的Whiplash患者与对照组相比，既有来自韧带的异常信号，也有在MRI上C0–C2水平的异常运动。患者的C1-C2水平异常运动比对照组更常见（56％比20％，P = 0.028）。具有长期症状的Whiplash患者与对照组相比，既有来自韧带的异常信号，也有在MRI上C0–C2水平的异常运动。患者的C1-C2水平异常运动比对照组更常见（56％比20％，P = 0.028）。具有长期症状的Whiplash患者与对照组相比，既有来自韧带的异常信号，也有在MRI上C0–C2水平的异常运动。