Diagnostic value of magnetic resonance diffusion tensor imaging in acute occult cervical spinal cord injury

Abstract

Objective To investigate the value of magnetic resonance diffusion tensor imaging (DTI) in the diagnosis of acute occult cervical spinal cord injury(CSCI). Methods Subjects were selected from the patients who were treated in orthopedics and neurosurgery department in hospital from June 2016 to July 2017. All the subjects had a clear history of trauma within 72 hours, and a non apparent abnormality of T2WI sequence and STIR sequence examination. Thirty patients joined the injured group and the control group contained 30 healthy volunteers. Both of them accepted MR sequence and DTI sequence examination respectively. Data processing and analysis were performed on both groups of DTIs to obtain diffusion tensor tractography (DTT). The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the two groups were measured respectively. Independent samples t-test was used to compare the differences between the two groups. Results The FA value of injured group (0.53±0.22) was significantly lower than that of control group (0.65 ± 0.12), the difference was statistically significant (t=5.00, P<0.01). The ADC value [(1.15±0.28)×10-3mm2/s] in injury group was significantly higher than that in the control group [(1.04±0.57)×10-3mm2/s], the difference was statistically significant (t=11.20, P<0.01). The DTT of the cervical spinal cord of injury group showed sparse, twisted and broken white matter in the damaged area. Conclusions The FA and ADC value of DTI can quantitatively analyze the severity of spinal cord white matter injury in CSCI patients. DTT can accurately depict the location and extent of white matter damage in the spinal cord. It is an important mean for noninvasive diagnosis of occult cervical spinal cord injury and prognosis evaluation. Key words: Magnetic resonance imaging; Diffusion tensor imaging; Spinal cord injury; Diffusion tensor tractography; Fractional anisotropy