Wei Corie W, Tharmakulasingam Januthy, Crawley Adrian, Kideckel David M, Mikulis David J, Bradbury Cheryl L, Green Robin E
Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Arch Phys Med Rehabil. 2008 Dec;89(12 Suppl):S85-91. doi: 10.1016/j.apmr.2008.07.005.
To characterize and differentiate cerebral white matter (WM) changes related selectively to traumatic brain injury (TBI) or spinal cord injury (SCI) in patients with SCIs in order to improve diagnostic accuracy of TBI in people with SCI.
Diffusion-tensor imaging (DTI)-derived fractional anisotropy (FA) data in WM tracts were compared between a healthy control and 2 patient groups. Between-subject comparisons of FA were performed using region of interest (ROI) analysis and tract-based spatial statistics.
A large, urban inpatient SCI program.
Three groups: SCI and concomitant TBI (SCI with TBI, n=7); SCI without TBI (SCI only, n=15); and healthy control subjects (n=12).
Not applicable.
FA was used as a measure of cerebral WM integrity.
ROI analyses showed reduced FA in the genu and splenium of the corpus callosum and forceps minor in patients with SCI with TBI compared with both healthy controls and patients with SCI only. ROI analyses did not show evidence of FA differences in patients with SCI only compared with controls. Tract-based spatial statistics did not demonstrate between-group differences in FA.
DTI is a sensitive tool to detect TBI-related WM damage in patients with SCI who have suffered concomitant TBI. No WM abnormalities on DTI could be attributed to SCI alone, although this finding should be further explored in future studies. Therefore, DTI may be a valuable tool to identify TBI in the SCI population. Further research to produce normative FA values is needed to allow identification of TBI in individual patients with SCI.
对脊髓损伤（SCI）患者中与创伤性脑损伤（TBI）或脊髓损伤（SCI）选择性相关的脑白质（WM）变化进行特征描述和鉴别，以提高SCI患者中TBI的诊断准确性。
比较健康对照组和2个患者组之间基于扩散张量成像（DTI）得出的WM束分数各向异性（FA）数据。使用感兴趣区域（ROI）分析和基于束的空间统计学方法对FA进行组间比较。
一个大型城市住院SCI项目。
三组：SCI合并TBI（SCI伴TBI，n = 7）；无TBI的SCI（仅SCI，n = 15）；以及健康对照者（n = 12）。
不适用。
FA用作脑WM完整性的指标。
ROI分析显示，与健康对照组和仅患SCI的患者相比，SCI伴TBI患者的胼胝体膝部和压部以及小钳的FA降低。ROI分析未显示仅患SCI的患者与对照组之间FA存在差异的证据。基于束的空间统计学未显示组间FA存在差异。
DTI是检测合并TBI的SCI患者中与TBI相关的WM损伤的敏感工具。DTI上未发现WM异常可单独归因于SCI，尽管这一发现应在未来研究中进一步探索。因此，DTI可能是在SCI人群中识别TBI的有价值工具。需要进一步研究以产生标准化的FA值，以便在个体SCI患者中识别TBI。
