Magnetic resonance imaging and magnetic resonance angiography in severe crush syndrome with consider

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Three cases of severe crush syndrome after the Wenchuan earthquake in China are presented. The patients, 2 males and one female ranging in age from 18-45 years were studied via 1.5 T magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). MRI examinations were performed more than twice on two patients within 60 days of the earthquake. All the patients had acute renal failure (ARF) with plasma myoglobin concentrations above 17 000 μg/L The T2-weighted and short time inversion recovery (STIR) sequences revealed high intensity lesions in the affected muscles, and enhanced T1 -weighted images showed enhancement of partial affected muscles. MRA revealed no signs of arterial occlusion, arteriostenosis, or filling defects of main arteries. All patients were managed medically with continuous venous-venous hemofiltration and other supportive care, and none required fasciotomy or amputation. Repeat MR studies showed that the high intensity lesions seen on the T2-weighted and STIR sequences resolved in parallel with improvement of laboratory studies and clinical course.
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