Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Nat Rev Neurol. 2019 Dec;15(12):718-731. doi: 10.1038/s41582-019-0270-5. Epub 2019 Oct 31.
Pathophysiological changes in the spinal cord white and grey matter resulting from injury can be observed with MRI techniques. These techniques provide sensitive markers of macrostructural and microstructural tissue integrity, which correlate with histological findings. Spinal cord MRI findings in traumatic spinal cord injury (tSCI) and nontraumatic spinal cord injury - the most common form of which is degenerative cervical myelopathy (DCM) - have provided important insights into the pathophysiological processes taking place not just at the focal injury site but also rostral and caudal to the spinal injury. Although tSCI and DCM have different aetiologies, they show similar degrees of spinal cord pathology remote from the injury site, suggesting the involvement of similar secondary degenerative mechanisms. Advanced quantitative MRI protocols that are sensitive to spinal cord pathology have the potential to improve diagnosis and, more importantly, predict outcomes in patients with tSCI or nontraumatic spinal cord injury. This Review describes the insights into tSCI and DCM that have been revealed by neuroimaging and outlines current activities and future directions for the field.
脊髓损伤后，脊髓白质和灰质的病理生理变化可以通过 MRI 技术观察到。这些技术提供了宏观和微观组织结构完整性的敏感标志物，与组织学发现相关。创伤性脊髓损伤 (tSCI) 和非创伤性脊髓损伤（最常见的形式是退行性颈椎脊髓病，DCM）的脊髓 MRI 发现，不仅为发生在焦点损伤部位的病理生理过程提供了重要的见解，也为脊髓损伤的头端和尾端提供了重要的见解。尽管 tSCI 和 DCM 的病因不同，但它们在远离损伤部位的脊髓病变程度上表现出相似性，这表明涉及类似的继发性退行性机制。对脊髓病变敏感的先进定量 MRI 方案有可能改善 tSCI 或非创伤性脊髓损伤患者的诊断，更重要的是，预测其预后。这篇综述描述了神经影像学揭示的 tSCI 和 DCM 的见解，并概述了该领域当前的活动和未来方向。
