Kim S-Y, Shin M J, Chang J H, Lee C-H, Shin Y-I, Shin Y B, Ko H-Y
1] Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea [2] Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea.
Spinal Cord. 2015 Aug;53(8):608-14. doi: 10.1038/sc.2015.57. Epub 2015 Apr 14.
This is a cross-sectional study.
The goal of this study was to characterize the diffusion properties across segments of the spinal cord and peak cerebrospinal fluid (CSF) velocities in the stenotic spinal canal, and to determine the correlation between these properties and clinical and electrophysiological parameters in patients with cervical spinal cord injury (SCI).
This study was conducted in the University teaching hospital.
The study involved 17 patients with cervical SCI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the spinal cord and peak systolic and diastolic velocities of CSF were measured at the level of maximum compression (region 1) and at the levels above (region 2) and below (region 3) the level of injury with no signal change in conventional magnetic resonance imaging. Neurological and electrophysiological parameters were measured, including American Spinal Injury Association (ASIA) Impairment Scale (AIS), ASIA motor score, ASIA sensory score, Modified Barthel Index, Spinal Cord Independence Measure III (SCIM III), somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP).
The ADC was significantly higher and the FA was significantly lower in regions 1, 2 and 3 of the SCI patients than in the normal controls (P<0.05 each). FA of the level below correlated with AIS, ASIA sensory score and SCIM III score, and FA of the level above correlated with SSEP latencies and MEP amplitudes (P<0.05 each). The reductions in FA correlated with CSF flow, functional measurements and evoked potentials.
Diffusion tensor imaging can be used to quantify the proximal and distal extents of spinal cord damage. Reductions in FA were correlated with CSF flow, functional measurements and evoked potentials.
这是一项横断面研究。
本研究的目的是描述脊髓各节段的扩散特性以及狭窄脊髓管内脑脊液（CSF）的峰值流速，并确定这些特性与颈脊髓损伤（SCI）患者的临床和电生理参数之间的相关性。
本研究在大学教学医院进行。
该研究纳入了17例颈脊髓损伤患者。在最大压迫水平（区域1）以及损伤水平上方（区域2）和下方（区域3）测量脊髓的表观扩散系数（ADC）和分数各向异性（FA），以及脑脊液的收缩期和舒张期峰值流速，这些区域在传统磁共振成像中无信号变化。测量神经和电生理参数，包括美国脊髓损伤协会（ASIA）损伤量表（AIS）、ASIA运动评分、ASIA感觉评分、改良巴氏指数、脊髓独立测量III（SCIM III）、体感诱发电位（SSEP）和运动诱发电位（MEP）。
SCI患者的区域1、2和3的ADC显著高于正常对照组，FA显著低于正常对照组（各P<0.05）。损伤水平以下的FA与AIS、ASIA感觉评分和SCIM III评分相关，损伤水平以上的FA与SSEP潜伏期和MEP波幅相关（各P<0.05）。FA的降低与脑脊液流动、功能测量和诱发电位相关。
扩散张量成像可用于量化脊髓损伤的近端和远端范围。FA的降低与脑脊液流动、功能测量和诱发电位相关。
