Abstract
Diffusion tensor MR imaging is emerging as an important tool for displaying anatomic changes in the brain after injury or disease but has been less widely applied to disorders of the spinal cord. The aim of this study was to characterize the diffusion properties of the entire human spinal cord in vivo during the chronic stages of spinal cord injury (SCI). These data provide insight into the structural changes that occur as a result of long-term recovery from spinal trauma. Thirteen neurologically intact subjects and 10 subjects with chronic SCI (>4 years postinjury) were enrolled in this study. A single-shot twice-refocused spin-echo diffusion-weighted echo-planar imaging pulse sequence was used to obtain axial images throughout the entire spinal cord (C1-L1) in <60 minutes. Despite heterogeneity in SCI lesion severity and location, diffusion characteristics of the chronic lesion were significantly elevated compared with those of uninjured controls. Fractional anisotropy was significantly lower at the chronic lesion and appeared dependent on the completeness of the injury. Conversely, mean diffusivity measurements in the upper cervical spinal cord in subjects with SCI were significantly lower than those in controls. These trends suggest that the entire neuraxis may be affected by long-term recovery from spinal trauma. These results suggest that diffusion tensor imaging may be useful in the assessment of SCI recovery.
Highlights
AND PURPOSE: Diffusion tensor MR imaging is emerging as an important tool for displaying anatomic changes in the brain after injury or disease but has been less widely applied to disorders of the spinal cord
Mean diffusivity measurements in the upper cervical spinal cord in subjects with spinal cord injury (SCI) were significantly lower than those in controls. These trends suggest that the entire neuraxis may be affected by long-term recovery from spinal trauma. These results suggest that diffusion tensor imaging may be useful in the assessment of SCI recovery
Diffusion tensor imaging (DTI) research in SCI largely involves the use of experimental animal models to examine changes in diffusivity that accompany the early stages of injury
Summary
The aim of this study was to characterize the diffusion properties of the entire human spinal cord in vivo during the chronic stages of spinal cord injury (SCI). The purpose of this study was to characterize the diffusion values of the entire spinal cord in humans with chronic SCI (Ͼ4 years postinjury) by using a clinically available pulse sequence and comparing these data with normative DTI characteristics reported previously.. The primary aim of this study was to characterize the diffusion properties across the entire spinal cord (C1–L1 vertebral levels) in humans with chronic SCI by using a clinically available DTI pulse sequence
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